Evaluation of two new filtration systems--Fenwal PS400 and Organon Teknika Curesis--and comparison of results with two centrifugation systems--IBM model 2997 and Haemonetics V50.

Two new filtration systems (Fenwal CPS 10TM - PS 400 and Organon Teknika Curesis - M82) were evaluated and compared with two centrifugal cell separators (IBM 2997 and Haemonetics V50). 11 patients with auto immune diseases and dermatological diseases underwent 230 consecutive plasma exchanges. For the filtration systems, the average whole blood rate was 50 ml/min and the plasma separation rate was about 21 ml/min for a transmembrane pressure about 70 mmHg. The pre/post percent reduction and sieving coefficient were calculated for some plasma and blood components. A variety of laboratory studies was monitored to assess the efficacy of plasma separators, their biocompatibility and some yields. These results show that the 2 filters appear safe and efficacious but their modules are too simple and do not offer a great security (no transmembrane pressure control or no extracorporeal fluid balance). For a blood banker, IBM 2997 seems more interesting if we take in account its characteristics during plasma exchanges and the possibility which is offered to carry out cytapheresis procedures. But for a thrombopenic patient the filtration systems keep their advantages.

On reversing the persistence of memory: hematopoietic stem cell transplant for autoimmune disease in the first ten years.

There has been a remarkable history in the treatment of patients with autoimmune disease in the last century. Prior to the development of newer NSAIDs and corticosteroids, the care of patients with autoimmune disease was limited to aspirin and generally homeopathic therapies such as paraffin. In the last 30 years, the introduction and acceptance of cytotoxic drugs such as methotrexate and cyclophosphamide have greatly advanced the treatment of patients with severe autoimmune diseases. However, the use and dose escalation of cytotoxic agents in severely ill patients is limited by toxicity and the potential for secondary malignancies that correlate with cumulative lifetime dosing. As hematopoietic stem cell transplant grew to become an established procedure for certain malignancies, reports of remission of coexistent autoimmune diseases began to emerge. Animal data subsequently supported a role for hematopoietic stem cell transplants for the primary indication of autoimmune diseases. On the basis of these reports, clinical trials of hematopoietic stem cell transplants for the primary indication of autoimmune disease were initiated in the late 1990s. We review the data from a decade of experience that has now accumulated for this novel approach to the management of autoimmunity.

Abatacept, nueva alternativa dentro de la familia de las terapias biológicas / Abatacept, new alternative within the family of the biological therapies

T cells are key mediators of adaptive immunity that are involved in both normal and abnormal immune responses (e.g. rheumatoid arthritis). The full activation of T cells requires two signals, the antigen specific and the costimulatory signals. In the absence of costimulation, T cells that recognize the antigen either fail to respond and die or enter a state of unresponsiveness known as anergy. Thus, costimulation has become an attractive target for therapy. After a long road, in December 2005, the US Food and Drug Administration approved CTLA-Ig (Abatacept) for the treatment of rheumatoid arthritis. Abatacept is the first of a new class of drugs that selectively modulates costimulation; in this case blocking the CD28 costimulatory pathway. We review the pharmacokinetic and pharmacodynamic properties, clinical efficacy, adverse effects, and indications of abatacept.

Ultradiluições e contaminação por mercúrio / High dilutions and contanination with mercury

A contaminação ambiental por inúmeros poluentes, como os metais, é uma triste realidade em centros urbanos e em áreas rurais. O Mercúrio (Hg) é um dos metais tóxicos de maior risco. O mercúrio pode causar grande número de desequilíbrios orgânicos mediados por processos imunológicos. Fica claro que existe uma base de susceptibilidade genética para os processos imunes desencadeados pela exposição a este contaminante, mercúrio inorgânico pode levar a alterações específicas de resposta auto-imune por desequilibrar a função granulocífica e desequilíbrios imunológicos mediados por IgG e IgE. Durante anos vêm se pesquisando formas para diminuir a toxicidade in vivo de metais, usando agentes quelantes ou outras substâncias competidoras. Que muitas vezes agravam o quadro imune. Outro método que mostra sua eficácia é o uso de ultradiluiçôes dos mesmos metais tóxicos, contribuindo também para o reequilíbrio da imunidade. Ultradiluições, por se basear no princípio da similitude e hormesis, podem atuar no controle dos níveis de contaminação deste metal no organismo e seus efeitos secundários no sistema imunitário. A proposta deste trabalho é discutir a ação da medicação ultradiluída no tratamento de pacientes com desequilíbrio imune após contaminação por mercúrio.(AU)

Mercury (hg) is one the pollutants involved in environmental contamination. It causes a large number of organic alterations mediated by immune reactions. The susceptibility to the latter has genetic basis. Inorganic Hg may cause specific alterations in the immune reactions through the unbalance of granulocytic and IgG-IgE function. Ways to reduce the in vivo toxicity of heavy metals has been sought for through the use of use of chelating and other competing agents. Another effective method for the rebalancing of the immune system is to use highly diluted amounts of the same metal involved. The action of high dilutions is based of the hormesis principle and they may control the levels of metals in human beings and the toxic effects of HGg on the immune system. This review discusses aspects of the contamination by Hg, focusing on the immunological ones and evaluates the effects of high dilutions on the treatment of Hg-contaminated patients.(AU)

Sindrome de Sjogren, posibilidades de tratamiento homeopatico / Sjogren Syndrome, homeopathic treatment possibilities

Presentamos una revision de las actualidades fisiopatologicas y terapeuticas del sindrome de Sjogren(SS), enfermedad autoinmune que se considera la segunda en prevalencia en los Estados Unidos, solo por detras de la Artritis Reumatoidea(AR). Asimismo incluimos un planteamiento teorico acerca de los medicamentos homeopaticos que pudiesen ser utiles en la terapia de esta enfermedad con base en el conocimiento de sus componentes y los mecanismos patologicos que estos producen, ademas de los resultados observados en un grupo de 6 pacientes con SS y manejados con homeopatia por un periodo de 3 a 6 meses posteriores al tratamiento. El resultado ha sido una remision total de los sintomas durante el tiempo que se tomo el medicamento, y en algunos casos, 6 meses despues de suspenderse este.

Apres la theorie, la pratique / After theory, practice

L'apport de quatre nouvelles souches en homeopathie, la cyclosporine, l'interleukine 2, un anticorps monoclonal anti-HLA-DR et un peptide anti-atypies cellulaires, est l'occasion pour l'auteur de dresser une revue d'ensemble des possibilites d'immunotherapie homeopathique du cancer. Ces quatre remedes peuvent constituer l'element eradicateur complementaire a la therapeutique par ADN-ARN et EGF dynamises et permettent de fonder de grands espoies sur les possibilites curatives de ces associations de remedes. Ce traitement constitue une plaque tournante immunitaire applicable avec une technique de prescription differente, non seulement a la cancerologie, mais aussi a la pathologie autoimmune ainqi qu'aux viroses graves y compris le sida. Trente cas personnels de patients atteints de sida et un protocole clinique en cours en Afrique sur 50 cas avec 50 cas temoins permettent a l'auteur d'annoncer des a present la place de choix de la therapeutique homeopathique dans cette affection redoutable. A plusieurs reprises, j'ai entretenu les lecteurs de cette revue de considerations plutot theoriques (4-5-6) et certains n'aurint pas cru a une quelconque portee pratique de pareils discours. Le moment est venu de leus donner tort. Dans un article preceden(7) j'ai cite des exemples d'extension du principe de similitude. Le succes de pneumococcinum dans l'herpes de type I, et de chlamydia, a continue a se verifier au point pour ce dernier, de redonner une allure juvenile a un adulte voute par sa spondylarthrite ankylosante. L'application en loi des semblables des ADN-ARN et de l'EGF s'est bien entendu poursuivie. Depuis l'annee 86 sont venus s'y ajouter quatre elements d'importance, puisqu'ils constituent le volet manquant de cette therapeutique en cancerologie: le traitement eradicateur, par immunotherapie lui aussi

Sindrome de Sjogren, posibilidades de tratamiento homeopatico / Sjogren Syndrome, homeopathic treatment possibilities

Presentamos una revision de las actualidades fisiopatologicas y terapeuticas del sindrome de Sjogren(SS), enfermedad autoinmune que se considera la segunda en prevalencia en los Estados Unidos, solo por detras de la Artritis Reumatoidea(AR). Asimismo incluimos un planteamiento teorico acerca de los medicamentos homeopaticos que pudiesen ser utiles en la terapia de esta enfermedad con base en el conocimiento de sus componentes y los mecanismos patologicos que estos producen, ademas de los resultados observados en un grupo de 6 pacientes con SS y manejados con homeopatia por un periodo de 3 a 6 meses posteriores al tratamiento. El resultado ha sido una remision total de los sintomas durante el tiempo que se tomo el medicamento, y en algunos casos, 6 meses despues de suspenderse este.(AU)