RESUMO
In a case-control study that included a total of 98 patients and 83 controls, the possible link between various pathogens and abdominal aortic aneurysms was investigated. For 68 patients with abdominal aortic aneurysm and age-matched controls, no differences were detected in the levels of immunoglobulin (Ig)A and IgG Chlamydiaceae and Chlamydophila pneumoniae antibodies. Patients with IgA titers positive for Chlamydophila pneumoniae showed progressive disease (defined as an annual increase of the aneurysm diameter of > or = 0.5 cm) more frequently than patients with negative IgA titers (p = 0.046). Polymerase chain reactions performed to detect DNA for Chlamydophila pneumoniae, Chlamydia trachomatis, Chlamydophila psittaci, human cytomegalovirus, Borrelia burgdorferi and Helicobacter pylori in tissue specimens of 30 patients and 15 controls were negative. In summary, Chlamydophila pneumoniae may contribute to aortic aneurysm disease progression, but DNA of this and other pathogens was not found in patients' specimens.
Assuntos
Anticorpos Antibacterianos/sangue , Aorta Abdominal/microbiologia , Aneurisma da Aorta Abdominal/microbiologia , Chlamydiaceae/imunologia , Chlamydophila pneumoniae/imunologia , DNA Bacteriano/análise , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Infecções por Chlamydia/imunologia , Infecções por Chlamydia/microbiologia , Chlamydiaceae/genética , Chlamydiaceae/isolamento & purificação , Infecções por Chlamydiaceae/imunologia , Infecções por Chlamydiaceae/microbiologia , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/isolamento & purificação , Feminino , Humanos , Imunoglobulina A/sangue , Imunoglobulina G/sangue , MasculinoRESUMO
During the budding process, human immunodeficiency virus (HIV) acquires several cellular proteins from the host. Thus, antibodies against self antigens found in sera patients with autoimmune disorders may cross react with host-derived or the HIV-specific proteins gp120 and gp41 on the viral envelope and probably neutralize HIV infection. To verify this hypothesis, 88 sera from HIV negative patients suffering from systemic lupus erythematosus (SLE) and other autoimmune disorders were analysed for cross reacting antibodies against HIV-1 by Western blot and FACS analysis indicating that antibodies cross-react with epitopes expressed on HIV infected or non-infected cells. Virus capture assays revealed that HIV-1(IIIB) was directly recognized by 60% of sera from patients with autoimmune disorders. Sera were also tested in HIV neutralization assays with stimulated T cells. Reduction of the viral load by patient sera correlated with their reactivity in Western blot analysis. Complement further enhanced the reduction of viral titres, although no complement-mediated lysis was observed. These data suggest a possible protective role of auto-antibodies against HIV infection in lupus patients.
Assuntos
Autoanticorpos/imunologia , Doenças do Tecido Conjuntivo/imunologia , Infecções por HIV/imunologia , HIV-1/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Adolescente , Adulto , Idoso , Autoanticorpos/farmacologia , Proteínas do Sistema Complemento/imunologia , Reações Cruzadas , Feminino , Citometria de Fluxo , Infecções por HIV/prevenção & controle , Soronegatividade para HIV , HIV-1/crescimento & desenvolvimento , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Neutralização , Linfócitos T/citologia , Linfócitos T/imunologia , Linfócitos T/virologia , Células U937 , Replicação Viral/imunologiaRESUMO
The aim of this study was to correlate results of therapeutic drug monitoring, genotypic resistance and viral response to lopinavir/ritonavir (LPV/r) or saquinavir/ritonavir (SQV/r) containing antiretroviral regimens. The retrospective short-term study included 20 patients with LPV/r and 20 patients with SQV/r containing highly active antiretroviral therapy (HAART). At baseline 7 LPV/r patients and 10 SQV/r patients had CD4+T cell counts above 410 cells/microl. After 6 months CD4+T cells had doubled in 5 LPV/r and 2 SQV/r patients. In LPV/r patients the mean serum concentration of lopinavir (LPV) was 2.6 ppm and 67% of all LPV/r samples had 50 or fewer viral copies/ml. In SQV/r patients the mean serum concentration of saquinavir (SQV) was 2.1 ppm. 79% of all SQV/r samples had 50 or fewer viruses/ml. Pharmacoenhanced regimens efficiently suppress human immunodeficiency virus type 1 (HIV-1) and the risk of developing resistance mutations is therefore reduced. The implementation of drug monitoring is an additional tool to determine optimal treatment conditions.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV-1 , Pirimidinonas/uso terapêutico , Ritonavir/uso terapêutico , Saquinavir/uso terapêutico , Adulto , Fármacos Anti-HIV/farmacocinética , Antígenos CD4/genética , Monitoramento de Medicamentos , Feminino , Genótipo , Anticorpos Anti-HIV/análise , Anticorpos Anti-HIV/biossíntese , Infecções por HIV/virologia , Protease de HIV/genética , HIV-1/enzimologia , HIV-1/genética , Humanos , Lopinavir , Masculino , Pessoa de Meia-Idade , Mutação , Neopterina/sangue , Pirimidinonas/farmacocinética , Estudos Retrospectivos , Ritonavir/farmacocinética , Saquinavir/farmacocinéticaRESUMO
In order to ascertain the epidemiology of rubella infections in Austria, a seroepidemiological study was performed. Data collected from 115 cases diagnosed at the Institute of Hygiene and Social Medicine of the University of Innsbruck during 2001 were evaluated. The results indicate this infection can no longer be categorised as a paediatric disease (mean age, 18.5 years), and several other findings were particularly striking: (i) 47% of the patients had elevated C-reactive protein levels and 50% had increased anti-streptolysin O titres; (ii) only a few patients complained of fever, while symptoms such as rash and lymphadenopathy, which are also associated with several other viral infections, including HIV, were found frequently; and (iii) the 115 rubella cases detected in the 1-year study period represented an incidence of >13 per 100,000 population. This high incidence of infection underlines the need for further improvement of diagnostic tests and more successful vaccine strategies.
Assuntos
Vacina contra Rubéola/administração & dosagem , Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Adolescente , Adulto , Distribuição por Idade , Áustria/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Rubéola (Sarampo Alemão)/diagnóstico , Índice de Gravidade de Doença , Distribuição por Sexo , Vacinação/normas , Vacinação/tendênciasRESUMO
The standard treatment for HIV infected patients is the highly active antiretroviral therapy. Due to resistance developments treatment failure can be found in some patients. In our study two different strategies are compared, which may reduce resistance mutations. Six patients (group A and B) have been monitored for about six years. Group A patients had a switch in their AZT-containing treatment to non AZT-containing regimens. In group B patients AZT-containing regimens' were interrupted by drug holidays. Early mono- and dual-therapies containing zidovudine (AZT) have been applied in all patients with poor long-term improvements. Due to the rapid development of escape mutants viral rebound was observed soon after treatment initiation. Genotypic assays were developed to asses AZT-resistance mutations. The longer AZT had been applied the more mutations had developed. These mutations disappeared when patients were taking "drug-holidays" and drug selection pressure was missing. Besides, it was demonstrated in two patients that these AZT-mutations could disappear, if in combination therapies AZT was replaced by other antiretroviral drugs. This study shows that not only by drug-holidays but also by switches in therapy mutations can disappear, which is especially important for patients with low CD 4 cell counts and high viral load levels.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Transcriptase Reversa do HIV/genética , HIV/genética , Mutação/efeitos dos fármacos , Inibidores da Transcriptase Reversa/uso terapêutico , Zidovudina/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Esquema de Medicação , Farmacorresistência Viral/genética , Genótipo , HIV/efeitos dos fármacos , Humanos , Resultado do Tratamento , Carga ViralRESUMO
Complement factor H (fH) is an important regulator of complement activation. It contributes to protection of cells against homologous complement attack. In this study we tested the effect of fH-depletion of normal human serum (NHS) on lysis of antibody-coated sheep and human erythrocytes (EshA and EhuA). In the absence of fH, lysis of sensitised Esh and Ehu was clearly increased. Addition of fH to fH-depleted serum re-established protection of cells against complement similar to that seen with NHS. A fH-derived peptide (pepAred), covering the N-terminal half of SCR 13 in fH, was able to enhance complement-mediated lysis of EhuA significantly. However, the oxidised form of this peptide (pepAox) had no effect. Biotinylated pepAred, but not pepAox, was able to directly bind to cells. Additionally, pepAred competed with direct fH-cell interaction which was observable only after treatment of purified fH with mercaptoethanol. Only pepAred increased the amount of C3 fragments and reduced levels of fH detectable on cells as shown by FACS analysis and radio-immuno assay. Furthermore, fH and factor I (fI)-mediated cleavage of agarose bound C3b into iC3b was decreased in the presence of pepAred. These data indicate that a fH-derived peptide can enhance complement-mediated lysis. We will continue to investigate whether the use of a fH peptide can be exploited for therapeutical purposes.