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1.
Turk J Med Sci ; 51(2): 835-847, 2021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-33078603

RESUMO

Background/aim: Nonsteroidal antiinflammatory drugs (NSAIDs) including diclofenac, naproxen, ibuprofen, acetylsalicylic acid, and acetaminophen have been shown to have antimicrobial effects on various microorganisms. The aim of this study was to investigate the antibacterial effects of NSAIDs on Staphylococcus aureus. Materials and methods: Susceptibilities of S. aureus strains to NSAIDs with or without antimicrobials (moxifloxacin, vancomycin, ciprofloxacin, clindamycin, and gentamicin) were determined using the microdilution method and disk diffusion test. Expression levels of genes in the presence of drugs were investigated by real-time quantitative RT-PCR (qRT-PCR), and immunoblotting analysis was performed for staphylococcal protein A (SpA). Results: Our results showed that all NSAIDs were active against S. aureus strains with MIC values ranging from 195 µg/mL to 6250 µg/ mL. NSAIDs increased the antibiotic susceptibility of the strains, and diclofenac was found to be more effective than the other drugs. Drugs showed different effects on expression levels of virulence factor and/or regulatory genes. Immunoblotting analysis of SpA protein was mostly in accordance with qRT-PCR results. Conclusion: The regulatory/virulence factor genes and proteins of S. aureus investigated in this study may be reasonable targets for these drugs, and we suggest that the data may contribute to the field of infection control and antimicrobial resistance.


Assuntos
Antibacterianos/farmacologia , Anti-Inflamatórios não Esteroides/farmacologia , Expressão Gênica/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos , Virulência/efeitos dos fármacos , Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Diclofenaco/farmacologia , Humanos , Testes de Sensibilidade Microbiana , Reação em Cadeia da Polimerase em Tempo Real , Infecções Estafilocócicas/tratamento farmacológico , Proteína Estafilocócica A/genética , Proteína Estafilocócica A/uso terapêutico , Staphylococcus aureus/genética , Virulência/genética , Fatores de Virulência/genética
2.
Arthritis Rheum ; 63(12): 3897-907, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22127707

RESUMO

OBJECTIVE: Cells of the monocytic lineage play fundamental roles in the regulation of health, ranging from the initiation and resolution of inflammation to bone homeostasis. In rheumatoid arthritis (RA), the inflamed synovium exhibits characteristic infiltration of macrophages along with local osteoclast maturation, which, together, drive chronic inflammation and downstream articular destruction. The aim of this study was to explore an entirely novel route of immunoglobulin-mediated regulation, involving simultaneous suppression of the inflammatory and erosive processes in the synovium. METHODS: Using in vivo and in vitro studies of human cells and a murine model of RA, the ability of staphylococcal protein A (SPA) to interact with and modulate cells of the monocytic lineage was tested. In addition, the efficacy of SPA as a therapeutic agent was evaluated in murine collagen-induced arthritis (CIA). RESULTS: SPA showed a capacity to appropriate circulating IgG, by generating small immunoglobulin complexes that interacted with monocytes, macrophages, and preosteoclasts. Formation of these complexes resulted in Fcγ receptor type I-dependent polarization of macrophages to a regulatory phenotype, rendering them unresponsive to activators such as interferon-γ. The antiinflammatory complexes also had the capacity to directly inhibit differentiation of preosteoclasts into osteoclasts in humans. Moreover, administration of SPA in the early stages of disease substantially alleviated the clinical and histologic erosive features of CIA in mice. CONCLUSION: These findings demonstrate the overarching utility of immunoglobulin complexes for the prevention and treatment of inflammatory diseases. The results shed light on the interface between immunoglobulin complex-mediated pathways, osteoclastogenesis, and associated pathologic processes. Thus, therapeutic agents designed to harness all of these properties may be an effective treatment for arthritis, by targeting both the innate inflammatory response and prodestructive pathways.


Assuntos
Complexo Antígeno-Anticorpo/uso terapêutico , Artrite Experimental/tratamento farmacológico , Diferenciação Celular/fisiologia , Imunoglobulinas/uso terapêutico , Inflamação/tratamento farmacológico , Osteoclastos/fisiologia , Proteína Estafilocócica A/uso terapêutico , Células-Tronco/fisiologia , Animais , Complexo Antígeno-Anticorpo/farmacologia , Antirreumáticos/farmacologia , Antirreumáticos/uso terapêutico , Artrite Experimental/imunologia , Artrite Experimental/fisiopatologia , Proliferação de Células , Células Cultivadas , Citocinas/fisiologia , Modelos Animais de Doenças , Humanos , Imunoglobulinas/fisiologia , Inflamação/fisiopatologia , Leucócitos Mononucleares/citologia , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/fisiologia , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Macrófagos/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Camundongos Knockout , Osteoclastos/citologia , Osteoclastos/efeitos dos fármacos , Receptores de IgG/genética , Receptores de IgG/fisiologia , Proteína Estafilocócica A/farmacologia , Células-Tronco/citologia , Células-Tronco/efeitos dos fármacos
3.
Science ; 209(4462): 1257-9, 1980 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-7403885

RESUMO

In dogs with spontaneous mammary adenocarcinomas, a single nontoxic infusion of cytosine arabinoside after extracorporeal perfusion of plasms over immobilized protein A resulted in a necrotizing response rapid in onset and specific for tumorous tissue. Gross tumoricidal reactions 12 hours after this combined treatment exceeded the algebraic sum of responses to cytosine arabinoside and protein A perfusion treatments alone in the same dogs, implying a synergistic effect between the two. The magnitude, rapidity, and specificity of the tumoricidal response after the combined treatment suggests that it may be an effective chemimmunotherapeutic approach to breast adenocarcinoma.


Assuntos
Adenocarcinoma/terapia , Citarabina/administração & dosagem , Neoplasias Mamárias Experimentais/terapia , Proteína Estafilocócica A/uso terapêutico , Animais , Anticorpos Antineoplásicos , Citarabina/uso terapêutico , Cães , Feminino , Imunoterapia , Neoplasias Mamárias Experimentais/imunologia , Neoplasias Mamárias Experimentais/patologia , Necrose , Perfusão , Proteína Estafilocócica A/imunologia , Staphylococcus aureus/imunologia
4.
Nephrol Dial Transplant ; 24(3): 864-9, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18840890

RESUMO

BACKGROUND: No established therapy is available for patients with lipoprotein glomerulopathy (LPG). Protein A immunoadsorption has been proved to be effective in reducing proteinuria in patients with nephrotic syndrome. In this uncontrolled pilot study, we investigated the efficiency of immunoadsorption onto staphylococcal protein A as treatment for LPG. METHODS: Thirteen patients with renal biopsy-proven LPG were treated with staphylococcal protein A immunoadsorption. Immunoadsorption was administered for 10 cycles per session and 10 sessions as a course. A total of 30 l of plasma was regenerated in each course. RESULTS: Single immunoadsorption course led to a rapid decline in proteinuria from 4.01 +/- 3.09 g/24 h to 1.21 +/- 0.97 g/24 h (mean +/- SD) (n = 13, P = 0.001), along with a dramatic decline in apolipoprotein E (apo E) from 9.79 +/- 5.04 mg/dl to 6.20 +/- 2.22 mg/dl (P = 0.004). A repeated renal biopsy (n = 12) showed that intraglomerular lipoprotein thrombi almost disappeared. Six patients were enrolled in the investigation of long-term outcome, and proteinuria returned to baseline levels within 12 months. Four recurrent patients received repeat immunoadsorption treatment; proteinuria decreased from 5.02 +/- 1.85 g/24 h to 1.64 +/- 0.55 g/24 h at the end of the treatment, serum apo E decreased from 14.65 +/- 11.17 mg/dl to 7.90 +/- 1.72 mg/dl. No patients suffered from severe complications. CONCLUSION: Our observations suggest that immunoadsorption onto protein A might be an effective treatment for resolving intraglomerular thrombi and improving nephrotic syndrome in patients with LPG. Further studies are required to define the influence of immunoadsorption on long-term effects in LPG patients.


Assuntos
Síndrome Nefrótica/terapia , Plasmaferese/métodos , Proteína Estafilocócica A/uso terapêutico , Adolescente , Adulto , Apolipoproteínas E/sangue , Feminino , Seguimentos , Humanos , Túbulos Renais/patologia , Masculino , Pessoa de Meia-Idade , Síndrome Nefrótica/sangue , Síndrome Nefrótica/patologia , Projetos Piloto , Proteinúria/etiologia , Proteinúria/patologia , Proteinúria/prevenção & controle , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
6.
Med Sci (Paris) ; 25(12): 1169-72, 2009 Dec.
Artigo em Francês | MEDLINE | ID: mdl-20035700

RESUMO

Recent advances in combinatorial protein engineering have made it possible to develop non-Ig protein scaffolds that can potentially substitute for most whole antibody-associated properties. These protein scaffolds display most of the binding properties associated with the variable domain of antibodies. In theory, many different natural human protein backbones are suitable to be used as recombinant templates for engineering ; in practice however, only a few have yielded the necessary properties to be translated into << druggable biologicals >>. Amongst these properties, potential broad specificities towards any kind of target, ease of production, small size, good tolerability and low immunogenicity are essential. Intellectual property is another key issue. In this review, a particular emphasis will be given to the most validated non-Ig scaffolds that have reached the clinical development phase.


Assuntos
Fragmentos de Peptídeos/química , Animais , Anti-Inflamatórios não Esteroides/química , Anti-Inflamatórios não Esteroides/uso terapêutico , Anticorpos , Antineoplásicos/química , Antineoplásicos/uso terapêutico , Biopolímeros , Ensaios Clínicos como Assunto , Desenho de Fármacos , Ensaios de Seleção de Medicamentos Antitumorais , Fibronectinas/química , Fibronectinas/uso terapêutico , Humanos , Inflamação/tratamento farmacológico , Camundongos , Camundongos Nus , Modelos Moleculares , Neoplasias/tratamento farmacológico , Neovascularização Patológica/tratamento farmacológico , Fragmentos de Peptídeos/uso terapêutico , Peptídeos/química , Peptídeos/uso terapêutico , Conformação Proteica , Engenharia de Proteínas , Estrutura Terciária de Proteína , Receptores de LDL/química , Receptores de LDL/uso terapêutico , Proteína Estafilocócica A/química , Proteína Estafilocócica A/uso terapêutico , Relação Estrutura-Atividade
7.
Mol Immunol ; 42(7): 849-55, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15829273

RESUMO

The (NZBxNZW) F(1) mouse develops a spontaneous autoimmune disease process with striking similarities to human systemic lupus erythematosus (SLE). In female (NZBxNZW) F(1) mice, the production of IgG antinuclear antibodies, including antibodies to double-stranded DNA (dsDNA), is associated with the development of a severe immune complex-mediated glomerulonephritis that results in death from renal failure in virtually all animals by 12 months of age. Since B-1 and marginal zone (MZ) cells represent a potential source of pathogenic antibodies and because B cell superantigens have been demonstrated to reduce B-1 and MZ cells in vivo, we tested the effect of repeated injections of the superantigen protein A (SpA) from S. aureus on the disease of this lupus model. We found that weekly intraperitoneal injections of SpA delay the progression of serum anti-DNA IgG and reduce proteinuria early in young female (NZBxNZW) F(1) mice. This superantigen also induced a specific depression in the numbers of peritoneal B-1 cells, as compared to mice treated with a control protein. These results support the role of B-1 cells in the development of the autoimmune disease in this mouse model and suggest that B cell superantigens may be useful in the management of autoimmune conditions.


Assuntos
Linfócitos B/imunologia , Glomerulonefrite/tratamento farmacológico , Proteína Estafilocócica A/uso terapêutico , Animais , Anticorpos Antinucleares/sangue , Complexo Antígeno-Anticorpo/imunologia , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/imunologia , Subpopulações de Linfócitos B , Feminino , Citometria de Fluxo , Glomerulonefrite/imunologia , Glomerulonefrite/patologia , Imunoglobulina G/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos NZB , Cavidade Peritoneal/citologia , Proteinúria , Baço/citologia , Staphylococcus aureus , Superantígenos/uso terapêutico
8.
Cancer Res ; 44(5): 2225-35, 1984 May.
Artigo em Inglês | MEDLINE | ID: mdl-6713411

RESUMO

Administration of plasma perfused over Protein A immobilized in collodion-charcoal produced focal acute tumor necrolytic reactions in breast adenocarcinomas. With repeated procedures, objective tumor regressions were observed in four of the first five consecutive patients treated. Within 4 to 48 hr after treatments, tumors became hyperemic and edematous, often with the appearance of focal vesicles. Microscopic and ultrastructural evaluation demonstrated a spectrum of lesions in cytoplasm and nucleus of tumor cells indicative of lethal and sublethal changes. With further treatments, more pronounced degenerative changes in individual tumor cells, tumor nodules, and intervening stroma were apparent. Furthermore, increased luminal and abluminal vesiculation of endothelial cells of postcapillary venules adjacent to tumor nodules was noted. With continued treatments at intervals of 2 to 3 days, some tumor sites showed focal mononuclear cell infiltration, and at the conclusion of plasma perfusion treatments previously ulcerated tumor foci were replaced by granulation tissue. These data suggest that several cytotoxic and inflammatory mechanisms are activated simultaneously or in succession and may account for the tumoricidal effects noted following repeated plasma perfusions.


Assuntos
Adenocarcinoma/patologia , Neoplasias da Mama/patologia , Proteína Estafilocócica A/uso terapêutico , Adenocarcinoma/terapia , Adenocarcinoma/ultraestrutura , Neoplasias da Mama/terapia , Neoplasias da Mama/ultraestrutura , Feminino , Humanos , Microscopia Eletrônica , Pessoa de Meia-Idade , Perfusão
9.
J Chin Med Assoc ; 79(7): 400-8, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27029995

RESUMO

BACKGROUND: Staphylococcal protein A (SPA) is a protein of Staphylococcus aureus. Up to now, there have been many studies on the biological activities of SPA. Some reported effects of SPA pretreatment on septic shock in mouse models but there is no study which reports the role of SPA pretreatment on the infected incision. METHODS: According to count results, bacterial suspension was set at a density of ∼1.8 × 10(9) colony forming units/mL. BALB/c mice were anesthetized via intraperitoneal injection with pentobarbital sodium. A longitudinal skin incision was made on the medial side of the right thigh. The length of the incision was 5 mm, and the depth was ∼3 mm. The bacterial suspension was gradually dripped and embrocated onto the incision surface to make the wound infection model. Before making the wound infection model for 48 hours and 24 hours, mice were retreated with SPA via intraperitoneal injection. Rats were intraperitoneally injected with SPA 1 mg/kg and the control group was injected with sterile saline to evaluate the biological safety of the best pretreatment dose. RESULTS: A 1-mL bacterial suspension can be utilized to make the wound infection model of BALB/c mouse lower limb. SPA pretreatment can reduce the inflammatory reactions in wound methicillin-resistant Staphylococcus aureus infection mouse model and the best pretreatment dose is 1 mg/kg. Intraperitoneal injection 1 mg/kg SPA does not destroy the functions of the organs. A 1-mg/kg SPA pretreatment can also reduce the inflammatory reactions in wound various bacterial infection mouse models. CONCLUSION: SPA pretreatment can effectively decrease the infected severity of a wound infected by various bacteria in a BALB/c mouse model. The best pretreatment dose is 1 mg/kg, and this dose does not damage organ function in rats up to a point.


Assuntos
Inflamação/tratamento farmacológico , Proteína Estafilocócica A/uso terapêutico , Infecção da Ferida Cirúrgica/tratamento farmacológico , Animais , Biofilmes , Camundongos , Camundongos Endogâmicos BALB C , Ratos , Ratos Wistar , Segurança , Proteína Estafilocócica A/toxicidade
10.
J Clin Oncol ; 4(2): 210-5, 1986 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3944604

RESUMO

Plasma perfusion over filters containing staphylococcal protein A (SPA) was used to treat 11 patients with adenocarcinoma who developed a hemolytic uremic syndrome. Immunoperfusion resulted in complete clearance of pretreatment elevated levels of circulating immune complexes in eight of the 11 patients with normalization of complement values depressed at the start of the therapy in seven. A significant rise in platelets and erythrocyte counts was achieved in nine patients, and stabilization of progressive renal impairment was achieved in six. The response was incomplete and short lived in three patients with clinically evident tumor recurrence, whereas long-term control of the syndrome was demonstrated in seven patients in complete tumor remission (no recurrence with median follow-up of 9 months). SPA immunoperfusion appears to be an effective form of therapy for this otherwise fatal syndrome.


Assuntos
Adenocarcinoma/complicações , Sangue , Síndrome Hemolítico-Urêmica/terapia , Proteína Estafilocócica A/uso terapêutico , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/imunologia , Idoso , Complexo Antígeno-Anticorpo/análise , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Complemento C3/análise , Complemento C4/análise , Feminino , Seguimentos , Síndrome Hemolítico-Urêmica/etiologia , Síndrome Hemolítico-Urêmica/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Ultrafiltração
11.
Ann N Y Acad Sci ; 1051: 591-6, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16126999

RESUMO

A pemphigus vulgaris (PV) patient with a 14-year history of severe and painful blistering of skin and mucous membranes as well as side effects from corticosteroids and concomitant immunosuppressive drug treatment was managed successfully by protein A immunoadsorption (IA). After 19 sessions of protein A IA, the patient showed remission of PV and healing of mucocutaneous lesions and the skin. The level of the pathogenic autoantibodies to the adhesion proteins desmoglein 1 (Dsg-1) and desmoglein 3 (Dsg-3) measured by ELISA and immunofluorescence microscopy revealed a significant removal of autoantibodies after each IA therapy. There was a weak rebound of anti-Dsg-1 and anti-Dsg-3 antibodies between IA sessions but an overall decrease over the period of IA therapy. This case demonstrates the effective use of protein A IA as an adjuvant and corticosteroid-sparing therapy in severe pemphigus refractory to standard immunosuppressive therapy and underscores the need for careful monitoring of autoantibodies.


Assuntos
Técnicas de Imunoadsorção , Pênfigo/terapia , Proteína Estafilocócica A/uso terapêutico , Autoanticorpos/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Pessoa de Meia-Idade , Pênfigo/imunologia
12.
Ther Apher Dial ; 9(3): 254-7, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15967001

RESUMO

Immunoadsorption is an adsorption technique for extracorporeal removal of circulating autoantibodies in autoimmune diseases. To prevent microbial growth during storage, the protein A columns are primed with thiomersal, which contains toxic ethyl mercury, which may be released during the procedure and potentially begin to accumulate and become toxic. To reduce the thiomersal-related mercury release during immunoadsorption treatment, we introduced a modified rinsing solution containing N-acetylcysteine, which is an avid mercury scavenger. Thirteen patients received 17 protein A immunoadsorption treatments and their venous blood samples were collected immediately before and after each session. The total blood mercury levels were measured by atomic absorption spectrometry, and the ethyl mercury levels by atomic fluorescence spectrometry. Following the manufacturer's recommendations, we used 600 mg of N-acetylcysteine to rinse the mercury from protein-loaded columns before each immunoadsorption treatment. After immunoadsorption, the ethyl mercury levels increased from 0.148 +/- 0.402 ng/g to 2.026 +/- 1.944 ng/g (P < 0.001), and the total blood mercury levels increased from 2.447 +/- 3.065 ng/g to 20.437 +/- 28.603 ng/g (P = 0.02). The post-treatment values of total blood mercury exceeded the upper safety level of 5 ng/g in all 17 immunoadsorption treatments, but no patient developed clinical signs of mercury toxicity. The results of our study showed an increase in total blood mercury and ethyl mercury levels during the immunoadsorption treatments, suggesting mercury release from thiomersal-primed columns despite the addition of N-acetylcysteine to the rinsing solution.


Assuntos
Acetilcisteína/farmacologia , Técnicas de Imunoadsorção , Imunoadsorventes/uso terapêutico , Conservantes Farmacêuticos/química , Proteína Estafilocócica A/uso terapêutico , Timerosal/antagonistas & inibidores , Síndrome Antifosfolipídica/terapia , Compostos de Etilmercúrio/sangue , Glomerulosclerose Segmentar e Focal/terapia , Humanos , Mercúrio/sangue , Mercúrio/química , Pessoa de Meia-Idade , Miastenia Gravis/terapia , Espectrometria de Fluorescência , Espectrofotometria Atômica , Timerosal/química
13.
Semin Hematol ; 26(2 Suppl 1): 19-24, 1989 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2658096

RESUMO

Protein A, a naturally occurring Staphylococcus aureus cell surface protein, has the unusual property of binding circulating immune complexes and immunoglobulin G with high avidity. CIC have played a major role in cancer-associated immunosuppression. Thus, removal of the immunosuppressive agents, ie, the CIC, may lead to a modulation of the immunosuppression and a liberation of the immune system to perform an antitumor effect. In animal studies, protein A has been used in extracorporeal immunoadsorption columns and treatments have resulted in tumor shrinkage and antiviral responses. Our group developed a multicenter clinical trial to assess toxicity and antitumor responses with this biologic response modifier alone. This is an update of our original trial. We have now treated 142 patients for a total of 1,306 treatments. The patients consisted of 74 males and 68 females. Their age ranged from 7 to 83 years, with a mean of 50 years. The Karnofsky performance index values ranged from 40 to 95, with a mean of 80. Patients who received seven or more treatments were considered eligible for tumor response assessment, and all patients with one or more treatments were eligible for toxicity assessment. Thus, there were 101 patients eligible for tumor response and 142 eligible for toxicity response. The total response rate was 22 patients or 21.8% (partial remission [PR], 12 patients, 12%; less than PR, 10 patients, 10%). Response rates were similar in the 13 treatment centers. Toxicity was assessed in 142 patients. One thousand three hundred six treatments were assessed for treatment toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Neoplasias/terapia , Proteína Estafilocócica A/uso terapêutico , Ensaios Clínicos como Assunto , Humanos , Técnicas de Imunoadsorção , Estudos Multicêntricos como Assunto , Proteína Estafilocócica A/efeitos adversos
14.
Semin Hematol ; 26(2 Suppl 1): 3-9, 1989 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2727721

RESUMO

Idiopathic thrombocytopenia purpura (ITP) is a primary immune thrombocytopenia that is typically manifested in adults by acute bleeding, severe thrombocytopenia, and normal to increased megakaryocytes in the bone marrow. Labeling studies suggest that most patients with ITP have an IgG antibody directed against the platelet membrane resulting in sequestration in the spleen. Splenectomy and/or corticosteroids remain the mainstay of therapy, with permanent remissions induced in 75% of patients. Despite the use of cyclophosphamide, azathioprine, vincristine, high-dose gamma globulin, and other forms of therapy, less than 50% of refractory patients achieve long-term satisfactory platelet counts. In view of these facts, ten consecutive patients with immune thrombocytopenia, unrelated to human immunodeficiency virus (HIV), received plasma perfusion over a staphylococcal protein A column (PROSORBA column) to evaluate efficacy and toxicity. All patients had an initial platelet count less than 50,000 and had failed corticosteroids. Five patients had also failed splenectomy. Two patients were not splenectomized due to pediatric age, two due to severe coexisting medical conditions, and one due to refusal of operation. Multiple other forms of therapy had also failed in this cohort of patients. Patients received two to ten treatments with the protein A column. All patients are evaluable for response and toxicities. Of the ten patients, results were as follows: complete response in one (platelet count greater than 150,000); partial response in four (platelet count greater than 50,000 and less than 150,000); and no response in five. Duration of responses ranged from 1 to 6 or more months.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Púrpura Trombocitopênica/terapia , Proteína Estafilocócica A/uso terapêutico , Formação de Anticorpos , Plaquetas/imunologia , Feminino , Humanos , Masculino , Contagem de Plaquetas/efeitos dos fármacos , Púrpura Trombocitopênica/imunologia , Proteína Estafilocócica A/efeitos adversos
15.
Semin Hematol ; 26(2 Suppl 1): 10-4, 1989 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2658094

RESUMO

Immunoadsorption therapy employing protein A columns (PROSORBA columns) was used for the treatment of patients with naturally occurring or transfusion-induced immune thrombocytopenia purpura (ITP). Plasma from one unit of blood was perfused through the columns and returned to each patient. This procedure was performed once or twice weekly. In two cases of acute ITP, platelets markedly increased, and platelet-associated IgG (Pa-IgG) and circulating immune complexes (CIC) were decreased following the treatments. A transient increase in platelets was achieved in one patient with chronic ITP. Some improved response to platelet transfusions was noticed in one patient with aplastic anemia and platelet alloimmunization. Two mechanisms are suggested for the effect of protein A column therapy: one is the stimulation of the production of anti-idiotype antibody that neutralizes platelet auto-antibody and the other is activation of complement that induces solubilization and removal of CIC containing platelet autoantibodies. Immunoadsorption by protein A column is a useful therapy for some ITP cases, especially those that are acute.


Assuntos
Púrpura Trombocitopênica/terapia , Proteína Estafilocócica A/uso terapêutico , Anticorpos/análise , Complexo Antígeno-Anticorpo/análise , Plaquetas/imunologia , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoglobulina G/análise , Técnicas de Imunoadsorção , Púrpura Trombocitopênica/imunologia , Proteína Estafilocócica A/efeitos adversos
16.
Semin Hematol ; 26(2 Suppl 1): 15-8, 1989 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2658095

RESUMO

Both antibodies and circulating immune complexes (CIC), which bind to platelets and induce the destruction and clearance of platelets by the reticuloendothelial system, are found in patients with human immunodeficiency virus (HIV) and immune thrombocytopenic purpura (ITP). IgG and CIC were removed from patients' plasma by extracorporeal immunoadsorption using protein A-silica columns (PROSORBA columns). Of the 36 HIV-positive ITP patients treated, 29 received more than one treatment and were evaluated for response. Sixteen patients showed more than a 50% increase in their platelet counts. Platelet-associated IgG (PAIgG) and/or platelet-directed IgG and CIC were elevated in all patients. After four to eight treatments, 16 of 29 patients showed a 170% to 430% increase in platelet counts. A decrease in CIC and PAIgG was noted in responding patients. The median duration of response to date was 8 to 12 months. This treatment was associated with immune modulation and the development of an anti-F (ab')2 antibody response. The antibody functions by complexing with both platelet-binding IgG and CIC, neutralizing their binding capacity for platelets and enhancing their clearance from the circulation. Nine patients with mitomycin-C-induced hemolytic uremic syndrome (HUS) were also treated with PROSORBA columns. Pretreatment platelet counts were markedly reduced while a definite increase in platelet counts was observed upon completion of therapy. There was a decrease of hemolysis and stabilization of renal function in three patients. PROSORBA column treatment has demonstrated marked activity against both HIV-ITP and HUS, and has successfully freed patients from the bleeding diathesis associated with these syndromes.


Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Síndrome Hemolítico-Urêmica/terapia , Púrpura Trombocitopênica/terapia , Proteína Estafilocócica A/uso terapêutico , Complexo Antígeno-Anticorpo/análise , Síndrome Hemolítico-Urêmica/complicações , Humanos , Imunoglobulina G/análise , Técnicas de Imunoadsorção , Púrpura Trombocitopênica/etiologia , Proteína Estafilocócica A/efeitos adversos
17.
Semin Hematol ; 26(2 Suppl 1): 25-30, 1989 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2543084

RESUMO

Sixteen feline leukemia virus (FeLV)-infected cats with lymphosarcoma (LSA) were treated by extracorporeal immunoadsorption using staphylococcal protein A columns in order to remove immunoglobulin G (IgG) and circulating immune complexes (CIC) from plasma. Complete viral clearance and long-lasting tumor regression were achieved in nine of the cats and tumor regression without virus clearance was observed in two other cats. Since LSA cats rarely go into spontaneous remission, and since other forms of therapy are ineffective, these cats offered a unique system for analyzing details of the immune response to LSA and FeLV as they are cleared. Immunological parameters associated with the FeLV and LSA responses were assessed in detail in three responder cats and three nonresponders during the treatment and follow-up periods. Two serological parameters that always correlated with complete clearance of LSA were development of precipitating antibodies against FeLV-C gp70 and development of cytotoxic antibodies that kill cultured FL74 LSA cells in the presence of complement. The precipitating antibodies were detected prior to the clearance of LSA and prior to the detection of free cytotoxic antibodies. One serological parameter that always correlated with complete clearance of. FeLV was development of free antibodies to FeLV-AB gp70. Quantitative levels of FeLV-specific CIC and feline oncornavirus-associated cell membrane antigen (FOCMA)-specific CIC correlated well with fluctuating levels of the corresponding antigens and antibodies. These results suggest that the staphylococcal protein A treatment columns remove CIC "blocking factors" directly or indirectly and thereby stimulate existing antibody responses. These antibodies mediate clearance of FeLV and LSA.


Assuntos
Leucemia Experimental/terapia , Linfoma não Hodgkin/terapia , Proteína Estafilocócica A/uso terapêutico , Animais , Especificidade de Anticorpos , Gatos , Técnicas de Imunoadsorção , Vírus da Leucemia Felina , Leucemia Experimental/complicações , Leucemia Experimental/imunologia , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/imunologia , Indução de Remissão
18.
Crit Rev Oncol Hematol ; 4(2): 103-24, 1985.
Artigo em Inglês | MEDLINE | ID: mdl-3905035

RESUMO

Tumoricidal responses and tumor regressions have been observed after plasma perfusion over Staphylococcus aureus Cowan I (SAC), or purified protein A immobilized on solid supports. This system was initially studied in a single human patient and then extended to dogs with spontaneous mammary carcinoma, an excellent model of human breast cancer. In the single patient and dogs with mammary tumors, perfusion of plasma over protein A bearing staphylococcus resulted in tumor necrosis and tumor regression. Tumor reduction or growth retardation with similar perfusion systems has been noted in various feline and rodent tumor models. Tumoricidal responses were also observed in canine tumors after perfusion over commercial protein A which was immobilized in a collodion charcoal matrix (PACC). These responses were amplified when a subtherapeutic and nontoxic dose of cytarabine was given after perfusion. Similar tumor reduction in murine and feline tumor models has been noted after perfusion of autologous serum over protein A immobilized on various other solid supports. The PACC perfusion system was extended to five consecutive patients with advanced breast adenocarcinoma. Four of five patients showed tumor regression after perfusion of small volumes of autologous or homologous plasma over PACC. Patients also experienced pyrexia, nausea, vomiting, and significant cardiopulmonary toxicity. Detailed hemodynamic studies of these effects showed that the major pathophysiology involved a decline in total peripheral resistance associated with an increase in cardiac output. With reduction of immobilized protein A quantity and diminution in plasma perfusion rate, the cardiopulmonary toxicity associated with treatments was diminished. Chemotherapy given as FAC to a single patient shortly after concluding perfusion therapy resulted in rapid regression of residual large tumor masses. Studies focusing on the mechanism of the tumoricidal responses have examined changes in sera after incubation or perfusion over immobilized SAC or PACC. Major findings include (1) the identification of protein A leaching from PACC and SAC after serum perfusion and appearing in the effluent as Clq binding oligomers composed predominantly of IgG and protein A but also containing IgA, IgM and C3 with a molecular weight range of 600,000 to 2,000,000; (2) the identification of C3a anaphylatoxins in serum perfused over PACC or SAC; (3) the recognition that several enterotoxins, in particular enterotoxin B are present in commercial protein A preparation.(ABSTRACT TRUNCATED AT 400 WORDS)


Assuntos
Neoplasias/terapia , Proteína Estafilocócica A/uso terapêutico , Staphylococcus/imunologia , Neoplasias Encefálicas/terapia , Neoplasias da Mama/terapia , Carvão Vegetal , Colódio , Preparações de Ação Retardada , Feminino , Humanos , Imunoterapia , Neoplasias/patologia , Perfusão , Proteína Estafilocócica A/toxicidade
19.
Transplantation ; 69(8): 1742-4, 2000 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-10836395

RESUMO

BACKGROUND: Haploidentical bone marrow transplantation with preexisting anti-HLA antibodies is associated with a high risk of graft failure. METHODS: A 27-year-old female patient with chronic myeloid leukemia and evidence of several osseous chloromas had no suitable matched bone marrow donor, and fluorescence cytometric cross-match (FCXM) revealed antibodies against donor-specific HLA-molecules. Immunoadsorption onto staphylococcal protein A was applied to remove these antibodies, and peripheral stem cell transplantation was performed from her haploidentical sister after a negative FCXM was documented after immunoadsorption and conditioning treatment. RESULTS: FCXM for donor lymphocytes and stem cells remained negative throughout the posttransplant period, and engraftment of donor cells was documented on day +69. CONCLUSION: Immunoadsorption onto protein A should be considered in stem cell transplantation even from an haploidentical donor where anti-HLA antibodies and a positive FCXM are documented.


Assuntos
Antígenos CD34/análise , Antígenos HLA/imunologia , Transplante de Células-Tronco Hematopoéticas , Imunização , Técnicas de Imunoadsorção , Proteína Estafilocócica A/uso terapêutico , Células-Tronco/imunologia , Adulto , Feminino , Citometria de Fluxo , Teste de Histocompatibilidade , Humanos
20.
Transplantation ; 63(7): 1040-2, 1997 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-9112365

RESUMO

V antigen is an established virulence factor of Yersinia pestis, the causative agent of bubonic plague. Injection of homogenous staphylococcal protein A-V antigen fusion peptide into mice was previously found to suppress tumor necrosis factor-alpha and interferon-gamma necessary for generation of protective granulomas. Here, we show that BALB/c mice receiving daily intraperitoneal injections of 100 microg of control protein A initiated rejection of C57BL/6 mouse tail skin grafts after 6.2+/-1.1 days. This time doubled to 12.2+/-1.4 days upon similar administration of protein A-V antigen fusion peptide (P<0.001); times of total allograft retention remained constant. This finding indicates that V antigen can postpone inflammation known to be associated with recognition and destruction of foreign tissue by T lymphocytes.


Assuntos
Antígenos de Bactérias/uso terapêutico , Rejeição de Enxerto/prevenção & controle , Transplante de Pele/imunologia , Proteína Estafilocócica A/uso terapêutico , Animais , Antígenos de Bactérias/genética , Feminino , Inflamação/prevenção & controle , Camundongos , Camundongos Endogâmicos BALB C , Proteínas Citotóxicas Formadoras de Poros , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/uso terapêutico , Proteína Estafilocócica A/genética , Transplante Homólogo
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