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1.
Clin Immunol ; 264: 110259, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38768856

RESUMEN

The gluten-free diet for celiac disease (CeD) is restrictive and often fails to induce complete symptom and/or mucosal disease remission. Central to CeD pathogenesis is the gluten-specific CD4+ T cell that is restricted by HLA-DQ2.5 in over 85% of CeD patients, making HLA-DQ2.5 an attractive target for suppressing gluten-dependent immunity. Recently, a novel anti-HLA-DQ2.5 antibody that specifically recognizes the complexes of HLA-DQ2.5 and multiple gluten epitopes was developed (DONQ52). OBJECTIVE: To assess the ability of DONQ52 to inhibit CeD patient-derived T-cell responses to the most immunogenic gluten peptides that encompass immunodominant T cell epitopes. METHODS: We employed an in vivo gluten challenge model in patients with CeD that affords a quantitative readout of disease-relevant gluten-specific T-cell responses. HLA-DQ2.5+ CeD patients consumed food containing wheat, barley, or rye for 3 days with collection of blood before (D1) and 6 days after (D6) commencing the challenge. Peripheral blood mononuclear cells were isolated and assessed in an interferon (IFN)-γ enzyme-linked immunosorbent spot assay (ELISpot) testing responses to gluten peptides encompassing a series of immunodominant T cell epitopes. The inhibitory effect of DONQ52 (4 or 40 µg/mL) was assessed and compared to pan-HLA-DQ blockade (SPVL3 antibody). RESULTS: In HLA-DQ2.5+ CeD patients, DONQ52 reduced T cell responses to all wheat gluten peptides to an equivalent or more effective degree than pan-HLA-DQ antibody blockade. It reduced T cell responses to a cocktail of the most immunodominant wheat epitopes by a median of 87% (IQR 72-92). Notably, DONQ52 also substantially reduced T-cell responses to dominant barley hordein and rye secalin derived peptides. DONQ52 had no effect on T-cell responses to non-gluten antigens. CONCLUSION: DONQ52 can significantly block HLA-DQ2.5-restricted T cell responses to the most highly immunogenic gluten peptides in CeD. Our findings support in vitro data that DONQ52 displays selectivity and broad cross-reactivity against multiple gluten peptide:HLA-DQ2.5 complexes. This work provides proof-of-concept multi-specific antibody blockade has the potential to meaningfully inhibit pathogenic gluten-specific T-cell responses in CeD and supports ongoing therapeutic development.


Asunto(s)
Anticuerpos Biespecíficos , Enfermedad Celíaca , Glútenes , Antígenos HLA-DQ , Humanos , Enfermedad Celíaca/inmunología , Glútenes/inmunología , Antígenos HLA-DQ/inmunología , Anticuerpos Biespecíficos/inmunología , Anticuerpos Biespecíficos/farmacología , Femenino , Epítopos de Linfocito T/inmunología , Adulto , Masculino , Linfocitos T CD4-Positivos/inmunología , Péptidos/inmunología , Persona de Mediana Edad , Linfocitos T/inmunología , Interferón gamma/inmunología , Interferón gamma/metabolismo , Epítopos Inmunodominantes/inmunología , Dieta Sin Gluten
2.
Clin Exp Immunol ; 204(3): 321-334, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33469922

RESUMEN

Whole blood cytokine release assays (CRA) assessing cellular immunity to gluten could simplify the diagnosis and monitoring of coeliac disease (CD). We aimed to determine the effectiveness of electrochemiluminescence CRA to detect responses to immunodominant gliadin peptides. HLA-DQ2·5+ CD adults (cohort 1, n = 6; cohort 2, n = 12) and unaffected controls (cohort 3, n = 9) were enrolled. Cohort 1 had 3-day gluten challenge (GC). Blood was collected at baseline, and for cohort 1 also at 3 h, 6 h and 6 days after commencing 3-day GC. Gliadin peptide-stimulated proliferation, interferon (IFN)-γ enzyme-linked immunospot (ELISPOT) and 14- and 3-plex electrochemiluminescence CRA were performed. Poisson distribution analysis was used to estimate responding cell frequencies. In cohort 1, interleukin (IL)-2 dominated the gliadin peptide-stimulated cytokine release profile in whole blood. GC caused systemic IL-2 release acutely and increased gliadin peptide-stimulated IFN-γ ELISPOT and whole blood CRA responses. Whole blood CRA after GC was dominated by IL-2, but also included IFN-γ, C-X-C motif chemokine ligand 10/IFN-γ-induced protein 10 (CXCL10/IP-10), CXCL9/monokine induced by IFN-γ (MIG), IL-10, chemokine (C-C motif) ligand 3/macrophage inflammatory protein 1-alpha (CCL3/MIP-1α), TNF-α and IL-8/CXCL8. In cohorts 2 and 3, gliadin peptide-stimulated whole blood IL-2 release was 100% specific and 92% sensitive for CD patients on a gluten-free diet; the estimated frequency of cells in CD blood secreting IL-2 to α-gliadin peptide was 0·5 to 11 per ml. Whole blood IL-2 release successfully mapped human leucocyte antigen (HLA)-DQ2·5-restricted epitopes in an α-gliadin peptide library using CD blood before and after GC. Whole blood IL-2 release assay using electrochemiluminescence is a sensitive test for rare gliadin-specific T cells in CD, and could aid in monitoring and diagnosis. Larger studies and validation with tetramer-based assays are warranted.


Asunto(s)
Enfermedad Celíaca/inmunología , Glútenes/inmunología , Interleucina-2/inmunología , Linfocitos T/inmunología , Adulto , Anciano , Quimiocina CXCL10/inmunología , Citocinas/inmunología , Epítopos de Linfocito T/inmunología , Femenino , Gliadina/inmunología , Antígenos HLA-DQ/inmunología , Humanos , Inmunidad Celular/inmunología , Interferón gamma/inmunología , Interleucina-8/inmunología , Masculino , Persona de Mediana Edad , Fragmentos de Péptidos/inmunología , Péptidos/inmunología , Adulto Joven
3.
Thromb J ; 18: 17, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32922211

RESUMEN

Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations.

4.
Anaerobe ; 44: 23-26, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28043924

RESUMEN

Mycotic aortic aneurysm is a rare and challenging complication of aortic homografts caused by an infection and is associated with high morbidity and mortality. We report the first case of an aortic cross homograft mycotic pseudoaneurysm caused by Robinsoniella peoriensis in a 70-year-old man. Our patient underwent surgery for a recurrence of aortic cross mycotic pseudoaneurysm at the level of the aortic homograft he had had 7 years before. A clot-removal of the pseudoaneurysm was surgically carried out and the homograft was completely removed. Anaerobic culture from tissue samples yielded pure growth of a spore-forming Gram-positive rod, identified later as Robinsoniella peoriensis by 16S rRNA gene sequencing. The patient was then discharged with oral clindamycin according to the in vitro susceptibility testing. Identification of R. peoriensis might be challenging in clinical laboratories with no access to molecular methods.


Asunto(s)
Aloinjertos/patología , Aneurisma Falso/etiología , Enfermedades de la Aorta/diagnóstico , Clostridiales/aislamiento & purificación , Infecciones por Bacterias Grampositivas/diagnóstico , Anciano , Aloinjertos/diagnóstico por imagen , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/microbiología , Aneurisma Falso/patología , Enfermedades de la Aorta/diagnóstico por imagen , Enfermedades de la Aorta/microbiología , Enfermedades de la Aorta/patología , Clostridiales/clasificación , Clostridiales/genética , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Infecciones por Bacterias Grampositivas/microbiología , Infecciones por Bacterias Grampositivas/patología , Humanos , Masculino , Tomografía Computarizada por Tomografía de Emisión de Positrones , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN
5.
Br J Surg ; 103(1): 51-9, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26560502

RESUMEN

BACKGROUND: This study aimed to describe national peripheral vascular disease (PVD) risk and health burden, and vascular care capacity in Ghana. The gap between PVD burden and vascular care capacity in low- and middle-income countries was defined, and capacity improvement priorities were identified. METHODS: Data to estimate PVD risk factor burden were obtained from the World Health Organization Study on Global Ageing and Adult Health (SAGE), Ghana, and the Institute of Health Metrics and Evaluation Global Burden of Disease (IHME GBD) database. In addition, a novel nationwide assessment of vascular care capacity was performed, with 20 vascular care items assessed at 40 hospitals in Ghana. Factors contributing to specific item deficiency were described. RESULTS: From the SAGE database, there were 4305 respondents aged at least 50 years with data to estimate PVD risk. Of these, 57·4 per cent were at moderate to risk high of PVD with at least three risk factors; extrapolating nationally, the estimate was 1 654 557 people. Based on IHME GBD data, the estimated disability-adjusted life-years incurred from PVD increased fivefold from 1990 to 2010 (from 6·3 to 31·7 per 100 000 persons respectively). Vascular care capacity assessment demonstrated marked deficiencies in items for diagnosis, and in perioperative and vascular surgical care. Deficiencies were most often due to absence of equipment, lack of training and technology breakage. CONCLUSION: Risk factor reduction and management as well as optimization of current resources are paramount to avoid the large burden of PVD falling on healthcare systems in low- and middle-income countries. These countries are not well equipped to handle vascular surgical care, and rapid development of such capacity would be difficult and expensive.


Asunto(s)
Creación de Capacidad , Países en Desarrollo , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Enfermedades Vasculares Periféricas/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Costo de Enfermedad , Femenino , Ghana/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Vasculares Periféricas/diagnóstico , Enfermedades Vasculares Periféricas/etiología , Enfermedades Vasculares Periféricas/terapia , Medición de Riesgo , Factores de Riesgo
6.
Org Biomol Chem ; 14(24): 5555-8, 2016 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-26924258

RESUMEN

As more methodologies for generating and manipulating biomimetic cellular systems are developed, opportunities arise for combining different methods to create more complex synthetic biological constructs. This necessitates an increasing need for tools to selectively trigger individual methodologies. Here we demonstrate ruthenium tris-bipyridine mediated photoredox triggering of the copper catalyzed alkyne azide cycloaddition reaction (CuAAC), resulting in the synthesis of biomimetic phospholipids in situ, and subsequent membrane assembly. The use of a ruthenium-copper electron transport chain to trigger phospholipid assembly opens up future opportunities for spatiotemporal synthesis of membranes.


Asunto(s)
Compuestos Organometálicos/química , Fosfolípidos/síntesis química , Rutenio/química , Estructura Molecular , Oxidación-Reducción , Fosfolípidos/química , Procesos Fotoquímicos , Piridinas/química
7.
Br J Cancer ; 110(12): 2855-64, 2014 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-24853186

RESUMEN

BACKGROUND: Insulin-like growth factors (IGF-I and IGF-II) signal via the type 1 IGF receptor (IGF-1R) and IGF-II also activates the insulin receptor isoform A (IR-A). Signalling via both receptors promotes tumour growth, survival and metastasis. In some instances IGF-II action via the IR-A also promotes resistance to anti-IGF-1R inhibitors. This study assessed the efficacy of two novel modified IGF-binding protein-2 (IGFBP-2) proteins that were designed to sequester both IGFs. The two modified IGFBP-2 proteins were either protease resistant alone or also lacked the ability to bind extracellular matrix (ECM). METHODS: The modified IGFBP-2 proteins were tested in vitro for their abilities to inhibit cancer cell proliferation and in vivo to inhibit MCF-7 breast tumour xenograft growth. RESULTS: Both mutants retained low nanomolar affinity for IGF-I and IGF-II (0.8-2.1-fold lower than IGFBP-2) and inhibited cancer cell proliferation in vitro. However, the combined protease resistant, non-matrix-binding mutant was more effective in inhibiting MCF-7 tumour xenograft growth and led to inhibition of angiogenesis. CONCLUSIONS: By removing protease cleavage and matrix-binding sites, modified IGFBP-2 was effective in inhibiting tumour growth and reducing tumour angiogenesis.


Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Proteína 2 de Unión a Factor de Crecimiento Similar a la Insulina/uso terapéutico , Neoplasias Mamarias Experimentales/tratamiento farmacológico , Neovascularización Patológica/tratamiento farmacológico , Secuencia de Aminoácidos , Animales , Sitios de Unión/genética , Proliferación Celular/efectos de los fármacos , Matriz Extracelular/genética , Femenino , Humanos , Proteína 2 de Unión a Factor de Crecimiento Similar a la Insulina/administración & dosificación , Factor I del Crecimiento Similar a la Insulina/metabolismo , Factor II del Crecimiento Similar a la Insulina/metabolismo , Células MCF-7 , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Datos de Secuencia Molecular , Unión Proteica , Proteínas Recombinantes/uso terapéutico , Ensayos Antitumor por Modelo de Xenoinjerto
8.
Am J Transplant ; 14(2): 404-15, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24472195

RESUMEN

Half of the recovered expanded criteria donor (ECD) kidneys are discarded in the United States. A new kidney allocation system offers kidneys at higher risk of discard, Kidney Donor Profile Index (KDPI)>85%, to a wider geographic area to promote broader sharing and expedite utilization. Dual kidney transplantation (DKT) based on the KDPI is a potential option to streamline allocation of kidneys which otherwise would have been discarded. To assess the clinical utility of the KDPI in kidneys at higher risk of discard, we analyzed the OPTN/UNOS Registry that included the deceased donor kidneys recovered between 2002 and 2012. The primary outcomes were allograft survival, patient survival and discard rate based on different KDPI categories (<80%, 80-90% and >90%). Kidneys with KDPI>90% were associated with increased odds of discard (OR=1.99, 95% CI 1.74-2.29) compared to ones with KDPI<80%. DKTs of KDPI>90% were associated with lower overall allograft failure (HR=0.74, 95% CI 0.62-0.89) and better patient survival (HR=0.79, 95% CI 0.64-0.98) compared to single ECD kidneys with KDPI>90%. Kidneys at higher risk of discard may be offered in the up-front allocation system as a DKT. Further modeling and simulation studies are required to determine a reasonable KDPI cutoff percentile.


Asunto(s)
Selección de Donante , Rechazo de Injerto/etiología , Fallo Renal Crónico/cirugía , Trasplante de Riñón/estadística & datos numéricos , Obtención de Tejidos y Órganos/estadística & datos numéricos , Anciano , Femenino , Estudios de Seguimiento , Rechazo de Injerto/diagnóstico , Rechazo de Injerto/mortalidad , Supervivencia de Injerto , Humanos , Fallo Renal Crónico/mortalidad , Trasplante de Riñón/efectos adversos , Masculino , Persona de Mediana Edad , Pronóstico , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Donantes de Tejidos
9.
Clin Exp Immunol ; 175(2): 305-15, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24192268

RESUMEN

T cell cytokine release assays are used to diagnose infectious diseases, but not autoimmune or allergic disease. Coeliac disease (CD) is a common T cell-mediated disease diagnosed by the presence of gluten-dependent intestinal inflammation and serology. Many patients cannot be diagnosed with CD because they reduce dietary gluten before medical workup. Oral gluten challenge in CD patients treated with gluten-free diet (GFD) mobilizes gluten-reactive T cells measurable by interferon (IFN)-γ enzyme-linked immunospot (ELISPOT) or major histocompatibility complex (MHC) class II tetramers. Immunodominant peptides are quite consistent in the 90% of patients who possess HLA-DQ2·5. We aimed to develop whole blood assays to detect gluten-specific T cells. Blood was collected before and after gluten challenge from GFD donors confirmed to have CD (n = 27, all HLA-DQ2·5(+) ), GFD donors confirmed not to have CD (n = 6 HLA-DQ2·5(+) , 11 HLA-DQ2·5(-) ) and donors with CD not following GFD (n = 4, all HLA-DQ2·5(+) ). Plasma IFN-γ and IFN-γ inducible protein-10 (IP-10) were measured by enzyme-linked immunosorbent assay (ELISA) after whole blood incubation with peptides or gliadin, and correlated with IFN-γ ELISPOT. No T cell assay could distinguish between CD patients and controls prior to gluten challenge, but after gluten challenge the whole blood IFN-γ ELISA and the ELISPOT were both 85% sensitive and 100% specific for HLA-DQ2·5(+) CD patients; the whole blood IP-10 ELISA was 94% sensitive and 100% specific. We conclude that whole blood cytokine release assays are sensitive and specific for detection of gluten-reactive T cells in CD; further clinical studies addressing the utility of these tests in patients with an uncertain diagnosis of CD is warranted.


Asunto(s)
Enfermedad Celíaca/diagnóstico , Quimiocina CXCL10/sangre , Ensayo de Inmunoadsorción Enzimática , Ensayo de Immunospot Ligado a Enzimas , Interferón gamma/sangre , Linfocitos T/inmunología , Adulto , Anciano , Enfermedad Celíaca/sangre , Quimiocina CXCL10/metabolismo , Femenino , Gliadina/inmunología , Glútenes/inmunología , Antígenos HLA-DQ/análisis , Antígenos HLA-DQ/inmunología , Humanos , Interferón gamma/metabolismo , Masculino , Persona de Mediana Edad , Adulto Joven
10.
Radiography (Lond) ; 30(1): 375-381, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38141431

RESUMEN

INTRODUCTION: Revisions to the UK Health and Care Professions Council (HCPC) standards of proficiency for diagnostic radiographers came into effect on September 1st 2023. Changes include an increase of proficiencies in CT and extended to MRI imaging. As workforce support the development of learners to meet stage outcomes in practice, this study aimed to understand the radiographers' expectations of future learners' training to meet the new standards of proficiency. METHODS: Snowball sampling was used to invite practice educators/student supervisors and department leads within the 21 NHS Trusts in the North East and Yorkshire region providing diagnostic radiography practice placements. Online focus groups used a semi structured topic guide to explore the expectations of student performance during different stages of their training, and on different types of pre-registration programmes. Participants views were sought on considerations for appropriate assessment. Thematic analysis was supported by NVivo software. RESULTS: Fifteen diagnostic radiographers across 11 NHS trusts participated in 5 focus groups in November 2022. The findings showed consistency in expectations of student performance in projectional radiography, patient care and communication. Participants felt some standards of proficiency were beyond threshold competency, or current practices were a barrier in supporting learning. Participants felt assessment over a period and range of examinations in the clinical environment gave a fairer picture of student performance. CONCLUSION: There is uncertainty and perceived barriers in supporting future diagnostic radiography training in the practice setting. IMPLICATIONS FOR PRACTICE: Further work will be needed to identify and support appropriate learning opportunities and stage outcomes if learners are to meet the breadth of HCPC standards of proficiency with some consistency.


Asunto(s)
Imagen por Resonancia Magnética , Estudiantes , Humanos , Grupos Focales , Radiografía , Reino Unido
11.
High Temp Corros Mater ; 101(3): 485-509, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38736430

RESUMEN

The effect of variations in Nb, Ta, and Ti concentrations in exchange for Al on the oxidation resistance of a new polycrystalline Ni-based superalloy (C19) was studied in air at 800 °C for up to 1000 h. An external scale of Ti-doped Cr2O3 and a sub-scale of discontinuous Al2O3 intrusions formed on the surface of all the studied alloys. Contrary to other reports, increasing the Nb concentration improved the oxidation performance and may have promoted the formation of a CrTaO4 layer, thereby reducing oxygen ingress. The addition of Ta also significantly improved oxidation resistance and reduced the depth of the Al2O3 intrusions. Increasing the Ti concentration did not significantly affect the oxidation performance, potentially due to the relatively low Ti concentrations investigated. Several of the studied alloys with modified Ta and Ti concentrations showed regions of continuous Al2O3 scale formation, suggesting that the compositions are in a transition regime between Cr2O3-forming and Al2O3-forming behaviour. The findings suggested that part of the Ti content in C19 could potentially be replaced with Nb, Ta and/or other elements to further enhance oxidation resistance and other desirable properties. Overall, the insights gained could serve as a guide to optimise the composition of C19 and similar alloys for enhanced oxidation resistance. Supplementary Information: The online version contains supplementary material available at 10.1007/s11085-023-10218-7.

12.
Genes Immun ; 14(2): 115-26, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23328844

RESUMEN

Transforming growth factor-ß (TGF-ß) maintains self-tolerance through a constitutive inhibitory effect on T-cell reactivity. In most physiological situations, the tolerogenic effects of TGF-ß depend on the canonical signaling molecule Smad3. To characterize how TGF-ß/Smad3 signaling contributes to maintenance of T-cell tolerance, we characterized the transcriptional landscape downstream of TGF-ß/Smad3 signaling in resting or activated CD4 T cells. We report that in the presence of TGF-ß, Smad3 modulates the expression of >400 transcripts. Notably, we identified 40 transcripts whose expression showed Smad3 dependence in both resting and activated cells. This 'signature' confirmed the non-redundant role of Smad3 in TGF-ß biology and identified both known and putative immunoregulatory genes. Moreover, we provide genomic and functional evidence that the TGF-ß/Smad3 pathway regulates T-cell activation and metabolism. In particular, we show that TGF-ß/Smad3 signaling dampens the effect of CD28 stimulation on T-cell growth and proliferation. The impact of TGF-ß/Smad3 signals on T-cell activation was similar to that of the mTOR inhibitor Rapamycin. Considering the importance of co-stimulation on the outcome of T-cell activation, we propose that TGF-ß-Smad3 signaling may maintain T-cell tolerance by suppressing co-stimulation-dependent mobilization of anabolic pathways.


Asunto(s)
Antígenos CD28/metabolismo , Linfocitos T CD4-Positivos/fisiología , Transducción de Señal , Proteína smad3/metabolismo , Factor de Crecimiento Transformador beta/metabolismo , Animales , Linfocitos T CD4-Positivos/metabolismo , Proliferación Celular , Inmunosupresores/farmacología , Activación de Linfocitos , Ratones , Ratones Noqueados , Sirolimus/farmacología , Proteína smad3/genética , Serina-Treonina Quinasas TOR/antagonistas & inhibidores
13.
Nat Genet ; 7(1): 13-21, 1994 May.
Artículo en Inglés | MEDLINE | ID: mdl-8075633

RESUMEN

We describe a strategy for producing human monoclonal antibodies in mice by introducing large segments of the human heavy and kappa light chain loci contained on yeast artificial chromosomes into the mouse germline. Such mice produce a diverse repertoire of human heavy and light chains, and upon immunization with tetanus toxin have been used to derive antigen-specific, fully human monoclonal antibodies. Breeding such animals with mice engineered by gene targeting to be deficient in mouse immunoglobulin (Ig) production has led to a mouse strain in which high levels of antibodies are produced, mostly comprised of both human heavy and light chains. These strains should provide insight into the adoptive human antibody response and permit the development of fully human monoclonal antibodies with therapeutic potential.


Asunto(s)
Anticuerpos Monoclonales/inmunología , Cromosomas Artificiales de Levadura , Genes de Inmunoglobulinas , Cadenas kappa de Inmunoglobulina/genética , Cadenas mu de Inmunoglobulina/genética , Ratones Transgénicos/inmunología , Proteínas Recombinantes de Fusión/biosíntesis , Adulto , Factores de Edad , Secuencia de Aminoácidos , Animales , Anticuerpos Monoclonales/biosíntesis , Anticuerpos Monoclonales/genética , Formación de Anticuerpos , Secuencia de Bases , Humanos , Hibridomas/inmunología , Cadenas kappa de Inmunoglobulina/biosíntesis , Cadenas mu de Inmunoglobulina/biosíntesis , Ratones , Datos de Secuencia Molecular , Proteínas Recombinantes de Fusión/inmunología , Alineación de Secuencia , Especificidad de la Especie , Toxina Tetánica/inmunología , Toxoide Tetánico/biosíntesis , Toxoide Tetánico/inmunología
14.
Med J Malaysia ; 68(1): 64-6, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23466770

RESUMEN

Awake craniotomy is a brain surgery in patients who are kept awake when it is indicated for certain intracranial pathologies. The anaesthetic management strategy is very important to achieve the goals of the surgery. We describe a series of our first four cases performed under a combination of scalp block and conscious sedation. Scalp block was performed using a mixture of ropivacaine 0.7% and adrenaline 5 5µg/ ml administered to the nerves that innervate the scalp. Conscious sedation was achieved with a combination of two recently available drugs in our country, dexmedetomidine (selective α 2-agonist) and remifentanil (ultra-short acting opioid). Remifentanil was delivered in a target controlled infusion (TCI) mode.


Asunto(s)
Dexmedetomidina , Cuero Cabelludo , Anestésicos , Sedación Consciente , Craneotomía , Humanos , Malasia
15.
Radiography (Lond) ; 29(5): 892-897, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37429251

RESUMEN

INTRODUCTION: Child safeguarding and the appropriate identification of suspected victims represents a global phenomenon. Diagnostic imaging is acknowledged as a contributory diagnostic service but the role of the radiographer in the identification and escalation process is less well understood. METHOD: A Knowledge, Attitude and Practice (KAP) survey was constructed to evaluate knowledge base in the context of the patient-radiographer interaction, the shaping of attitude towards child safeguarding and attitudes held towards their role plus the actual practical experiences of managing child safeguarding concerns. RESULTS: Respondents demonstrated a inconsistent knowledge base with respect to physical, social and radiographic signs and symptoms of child safeguarding concern. A positive attitude towards the role of the radiographer in child safeguarding was demonstrated but one that was shaped more by experience than pre-registration education. Assessment of concerns was chiefly influenced by clinical history and appreciation of aetiology. Practically, radiographers have infrequent involvement with the identification and escalation of concerns. Whilst some statistically significant relationships between responses and demographics did exist, these were either sporadic or argued to be a result of natural variation. CONCLUSION: Assessment of physical and social signs of child safeguarding concern are argued to be becoming more challenging. Radiological signs continue to be visible to radiographers but with increasing use of other imaging modalities these signs are becoming more varied in nature and are providing new challenges. Radiographers are capable of escalation when required to do so. IMPLICATIONS FOR PRACTICE: To maximise the contribution of the profession, education needs to account for imaging modality worked with, in combination with an understanding of related aetiology. Previously existing concerns with respect to escalating processes are no longer in evidence and radiographers are both willing and able to contribute to that process.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Radiología , Humanos , Niño , Radiografía , Encuestas y Cuestionarios , Técnicos Medios en Salud
16.
High Temp Corros Mater ; 100(1-2): 85-108, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37456797

RESUMEN

An assessment is made of the Wagner transition criteria for predicting the formation of a continuous Al2O3 scale in Ni-based superalloys. Predictions are compared with data from an experimental Ni-based superalloy as well as commercial superalloys for which published data are available. The methodology was generally successful in predicting the transition temperature of the commercial superalloys but underpredicted the transition temperature of the experimental superalloy by approximately 50-100 °C. The difference in the transition temperature of the experimental superalloy to form a continuous Al2O3 scale is primarily attributed to a complex oxide subscale that increased the internal volume fraction of oxide and led to reduced oxygen ingress. The sensitivity and limitations of the methodology are discussed, and recommendations are made to refine the methodology to facilitate the interpretation of oxidation behaviour in polycrystalline Ni-based superalloys. Supplementary Information: The online version contains supplementary material available at 10.1007/s11085-023-10163-5.

17.
Adv Clin Chem ; 114: 151-223, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37268332

RESUMEN

D-dimer containing species are soluble fibrin degradation products derived from plasmin-mediated degradation of cross-linked fibrin, i.e., 'D-dimer'. D-dimer can hence be considered a biomarker of in vivo activation of both coagulation and fibrinolysis, the leading clinical application in daily practice of which is ruling out venous thromboembolism (VTE). D-dimer has been further evaluated for assessing the risk of VTE recurrence and helping define optimal duration of anticoagulation treatment in VTE, for diagnosing disseminated intravascular coagulation (DIC), and for screening those at enhanced risk of VTE. D-dimer assays should however be performed as intended by regulatory agencies, as their use outside these indications might make them a laboratory-developed test (LDT). This narrative review is aimed at: (1) reviewing the definition of D-dimer, (2) discussing preanalytical variables affecting D-dimer measurement, (3) reviewing and comparing the assays performance and some postanalytical variables (e.g., different units and age-adjusted cutoffs), and (4) discussing the interest of D-dimer measurement across different clinical settings, including pregnancy, cancer, and coronavirus disease 2019 (COVID-19).


Asunto(s)
COVID-19 , Coagulación Intravascular Diseminada , Tromboembolia Venosa , Embarazo , Femenino , Humanos , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Productos de Degradación de Fibrina-Fibrinógeno/uso terapéutico , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/tratamiento farmacológico , COVID-19/diagnóstico , Coagulación Intravascular Diseminada/diagnóstico , Pruebas de Coagulación Sanguínea
18.
Am J Transplant ; 12(8): 2098-105, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22758926

RESUMEN

The number of kidneys obtained from deceased diabetic donors available for transplantation has increased >eightfold increase in the past 15 years. We assessed allograft outcomes associated with deceased diabetic donors and compared them with that of standard and extended criteria donors (ECD) in the UNOS data registry. We identified 1982 recipients of diabetic standard criteria donors over a 10-year period from 1995 through 2004. Both overall and death-censored survival of organs from diabetic standard criteria donors was significantly better than that of organs obtained from nondiabetic ECD while inferior to that from nondiabetic standard criteria donors. Compared with ECD donors, diabetic donors had lower serum creatinine, less cold ischemia and these kidneys were less likely to be pump-perfused. Recipients of diabetic kidneys were younger and less likely to experience delayed graft function compared with recipient of ECD kidneys. More recently, many diabetic donor kidneys have been given to diabetic recipients with early graft survival being similar to that among nondiabetic recipients. These findings demonstrate the potential to expand and to improve utilization of this resource without compromising outcomes for recipients. Improved, evidence-based evaluation and allocation of deceased diabetic donor kidneys is needed to optimize their use.


Asunto(s)
Diabetes Mellitus/fisiopatología , Trasplante de Riñón , Sistema de Registros , Obtención de Tejidos y Órganos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Estados Unidos
19.
Ecotoxicol Environ Saf ; 75(1): 73-9, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21862128

RESUMEN

The potential toxicity of decabromodiphenyl ethane (DBDP-Ethane) was explored in 5 types of organisms residing in the water column and/or sediment, e.g. Oncorhynchus mykiss, Pseudokirchneriella subcapitata, Daphnia magna, Chironmus riparius, and Lumbriculus variegates. Fish, algae or Daphnia were unaffected by acute exposures to water accommodated fractions of 110mg DBDP-Ethane/L. Chronic exposure to DBDP-Ethane at the highest dose tested, 5000mg/kg dry sediment, did not affect midge mean development times, emergence or development rates or oligochaete survival, reproduction or dry weight. The chronic EC50, LOEC and NOEC were ≥5000mg/kg in the two sediment species. Applying an assessment factor of 50, the unbounded predicted no effect concentration (PNEC(sediment)) was 100mg/kg dry sediment. The calculated PNEC indicates DBDPE-Ethane presents little risk to sediment organisms. These results add to DBDP-Ethane's existing database in the terrestrial compartment and mammals.


Asunto(s)
Bromobencenos/toxicidad , Contaminantes Químicos del Agua/toxicidad , Animales , Chironomidae/efectos de los fármacos , Chlorophyta/efectos de los fármacos , Daphnia/efectos de los fármacos , Daphnia/crecimiento & desarrollo , Sedimentos Geológicos/química , Oligoquetos/efectos de los fármacos , Oncorhynchus mykiss , Reproducción/efectos de los fármacos , Medición de Riesgo
20.
Ecotoxicol Environ Saf ; 74(4): 703-10, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21111479

RESUMEN

Decabromodiphenyl ethane (DBDP-Ethane) was evaluated for its potential to effect sewage sludge respiration, soil nitrification, survival and reproduction in Eisenia fetida, and seedling emergence and growth in Zea mays, Lolium perenne, Glycine max, Allium cepa, Lycopersicon esculentum, and Cucumis sativa. The no observed effect concentrations (NOECs) were identified at the limit concentration level for sewage sludge respiration (>10 mg DBDP-Ethane/kg dry soil), >2500 mg/kg dry soil for soil nitrification, >3720 mg/kg dry soil for earthworm survival, and >6250 mg/kg dry soil for seedling emergence and growth in Z. mays, L. perenne, and G. max . Treatment-related effects were identified for E. fetida reproduction, C. sativa survival, and L. esculentum and A. cepa height and dry weight. The most sensitive endpoints were decreased height and dry weight for A. cepa and decreased reproduction for E. fetida with NOECs of 1563(nominal) (1540(measured)) and 2210(nominal) (1907(mean measured)) mg/kg dry soil. The NOEC for soil nitrification and the lowest NOEC identified for soil (i.e., A. cepa) were used to derive predicted no effect concentrations (PNEC) values of 2500 mg/kg for sewage sludge and 156 mg/kg for soil. The calculated PNECs indicate DBDP-Ethane presents little risk to organisms in the sewage sludge and soil compartments.


Asunto(s)
Bromobencenos/toxicidad , Oligoquetos/efectos de los fármacos , Contaminantes del Suelo/toxicidad , Animales , Bacterias/efectos de los fármacos , Cucumis sativus/efectos de los fármacos , Cucumis sativus/crecimiento & desarrollo , Retardadores de Llama/toxicidad , Cadena Alimentaria , Lolium/efectos de los fármacos , Lolium/crecimiento & desarrollo , Solanum lycopersicum/efectos de los fármacos , Solanum lycopersicum/crecimiento & desarrollo , Nitrificación/efectos de los fármacos , Nivel sin Efectos Adversos Observados , Oligoquetos/crecimiento & desarrollo , Oligoquetos/fisiología , Cebollas/efectos de los fármacos , Cebollas/crecimiento & desarrollo , Reproducción/efectos de los fármacos , Plantones/efectos de los fármacos , Plantones/crecimiento & desarrollo , Aguas del Alcantarillado/química , Aguas del Alcantarillado/microbiología , Suelo/química , Microbiología del Suelo , Zea mays/efectos de los fármacos , Zea mays/crecimiento & desarrollo
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