Immunopathology & Immunotherapy
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Immunopathology & Immunotherapy
Latest advances in immunopathology diagnosis and treatment
Curated by Alfredo Corell
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Informes Diagnósticos en Inmunodeficiencias 2016 - cursos GECLID con créditos cFc (5ª EDICIÓN)

Informes Diagnósticos en Inmunodeficiencias 2016 - cursos GECLID con créditos cFc (5ª EDICIÓN) | Immunopathology & Immunotherapy | Scoop.it

OBJETIVOS:
•    Repasar las pruebas diagnósticas Inmunológicas para el Diagnóstico y Seguimiento de Inmunodeficiencias Primarias (Combinadas y de Anticuerpos).
•    Conocer las presentaciones clínicas de las patologías de IDPs más frecuentes.
•    Entender la correlación de las manifestaciones clínicas con las pruebas analíticas en IDPs.
•    Ser capaces de emitir un informe diagnóstico de calidad, preciso y entendible para los clínicos.
•    Ser capaces de proponer el abordaje terapéutico de las patologías diagnosticadas.

Alfredo Corell's curator insight, October 17, 2016 5:31 PM

Comienzo inminente de la 5ª edición de este prestigioso curso.

Descripción general

El objetivo de este curso es el reciclaje y actualización de profesionales de la inmunología clínica en el campo de las Inmunodeficiencias.

 

PROFESORADO:
•    Alfredo Corell Almuzara (Inmunólogo, Profesor Titular de Inmunología Univ. Valladolid).
•    Ignacio González (Pediatra, Hospital 12 de Octubre).

REQUISITOS DE LOS PARTICIPANTES:
Disponer de conexión diaria a internet (y dirección de correo electrónico) para acceder al Campus Virtual de GECLID-SEI, donde se realizará el curso (www.geclid.es).

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Rare Disease Day 2015 - Feb 28 - Download and share our communication materials

Rare Disease Day 2015 - Feb 28 - Download and share our communication materials | Immunopathology & Immunotherapy | Scoop.it
Be part of the international movement and use the Rare Disease Day official international communication materials found here!
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Primary Immunodeficiencies are also among the Rare diseases. Thus, please... share the communication materials about the Rare Diseases Day :)

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Personalized medicine against hereditary immunodeficiency

Personalized medicine against hereditary immunodeficiency | Immunopathology & Immunotherapy | Scoop.it
Researchers have found a method to repair the gene mutation causing agammaglobulinemia, an immunodeficiency disease that almost exclusively affects boys and in which the body lacks the ability to produce immunoglobulins (gamma globulin). The disease is characterized by recurring bacterial infections, mainly in the respiratory system, and persons who suffer from the illness currently need life-long gamma globulin treatment.
Alfredo Corell's insight:

X-linked agammaglobulinemia (XLA) is an inherited immunodeficiency that results from mutations within the gene encoding Bruton’s tyrosine kinase (BTK). Many XLA-associated mutations affect splicing of BTK pre-mRNA and severely impair B cell development. Here, we assessed the potential of antisense, splice-correcting oligonucleotides (SCOs) targeting mutated BTK transcripts for treating XLA. Both the SCO structural design and chemical properties were optimized using 2′-O-methyl, locked nucleic acid, or phosphorodiamidate morpholino backbones. In order to have access to an animal model of XLA, we engineered a transgenic mouse that harbors a BAC with an authentic, mutated, splice-defective human BTK gene. BTK transgenic mice were bred onto a Btk knockout background to avoid interference of the orthologous mouse protein. Using this model, we determined that BTK-specific SCOs are able to correct aberrantly spliced BTK in B lymphocytes, including pro–B cells. Correction of BTK mRNA restored expression of functional protein, as shown both by enhanced lymphocyte survival and reestablished BTK activation upon B cell receptor stimulation. Furthermore, SCO treatment corrected splicing and restored BTK expression in primary cells from patients with XLA. Together, our data demonstrate that SCOs can restore BTK function and that BTK-targeting SCOs have potential as personalized medicine in patients with XLA.


GO TO THE JOURNAL OF CLINICAL INVESTIGATION MANUSCRIPT:

http://www.jci.org/articles/view/76175

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Are complement deficiencies really rare? Overview on prevalence,
clinical importance and modern diagnostic approach

Are complement deficiencies really rare? Overview on prevalence,<br/>clinical importance and modern diagnostic approach | Immunopathology & Immunotherapy | Scoop.it
http://www.bragid.org.br/_download/artigos/are_complement_def_rare.pdf
Alfredo Corell's insight:

Complement deficiencies comprise between 1 and 10% of all primary immunodeficiencies (PIDs) accord-ing to national and supranational registries. They are still considered rare and even of less clinicalimportance. This not only reflects (as in all PIDs) a great lack of awareness among clinicians and gen-eral practitioners but is also due to the fact that only few centers worldwide provide a comprehensivelaboratory complement analysis. To enable early identification, our aim is to present warning signs forcomplement deficiencies and recommendations for diagnostic approach. The genetic deficiency of anyearly component of the classical pathway (C1q, C1r/s, C2, C4) is often associated with autoimmune dis-eases whereas individuals, deficient of properdin or of the terminal pathway components (C5 to C9), arehighly susceptible to meningococcal disease. Deficiency of C1 Inhibitor (hereditary angioedema, HAE)results in episodic angioedema, which in a considerable number of patients with identical symptomsalso occurs in factor XII mutations. New clinical entities are now reported indicating disease associa-tion with partial complement defects or even certain polymorphisms (factor H, MBL, MASPs). Mutationsaffecting the regulators factor H, factor I, or CD46 and of C3 and factor B leading to severe dysregulationof the alternative pathway have been associated with renal disorders, such as atypical hemolytic uremicsyndrome (aHUS) and – less frequent – with membranoproliferative glomerulonephritis (MPGN). Wesuggest a multi-stage diagnostic protocol starting based on the recognition of so called warning signswhich should aid pediatricians and adult physicians in a timely identification followed by a step-wisecomplement analysis to characterize the defect at functional, protein and molecular level.© 2014 Published by Elsevier 

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Review of Primary Immunodeficiencies - The Asthma Center

Review of Primary Immunodeficiencies - The Asthma Center | Immunopathology & Immunotherapy | Scoop.it

A small review about Immunodeficiencies. A "must" visit por Immunology students.

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You can also download the printable pdf of the review:  http://www.asthmacenter.com/uploads/ID%20printable.pdf

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XMEN disease: a new primary immunodeficiency affecting Mg2+ regulation of immunity against Epstein-Barr virus

XMEN disease: a new primary immunodeficiency affecting Mg2+ regulation of immunity against Epstein-Barr virus | Immunopathology & Immunotherapy | Scoop.it
  1. Feng-Yen Li1
  2. Benjamin Chaigne-Delalande1
  3. Helen Su2
  4. Gulbu Uzel3,
  5. Helen Matthews1, and 
  6. Michael J. Lenardo1,*
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Blood 

  • Submitted November 19, 2013.
  • Accepted February 7, 2014.


Epstein Barr virus (EBV) is an oncogenic gammaherpesvirus that infects and persists in 95% of adults worldwide and has the potential to cause fatal disease, especially lymphoma, in immunocompromised hosts. Primary immunodeficiencies (PIDs) that predispose to EBV-associated malignancies have provided novel insights into the molecular mechanisms of immune defense against EBV. We have recently characterized a novel PID now named "X-linked immunodeficiency with magnesium defect, Epstein-Barr virus (EBV) infection, and neoplasia" (XMEN) disease characterized by loss-of-function mutations in the gene encoding magnesium transporter 1 (MAGT1), chronic high level EBV with increased EBV-infected B cells, and heightened susceptibility to EBV-associated lymphomas. The genetic etiology of XMEN disease has revealed an unexpected quantitative role for intracellular free magnesium in immune functions and led to novel diagnostic and therapeutic strategies. Here, we review the clinical presentation, genetic mutation spectrum, molecular mechanisms of pathogenesis, and diagnostic and therapeutic considerations for this previously unrecognized disease.

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Actin cytoskeletal defects in immunodeficiency: a UCL Discovery

Actin cytoskeletal defects in immunodeficiency: a UCL Discovery | Immunopathology & Immunotherapy | Scoop.it
Open Access UCL Research: Actin cytoskeletal defects in immunodeficiency. http://t.co/GUckDlnylL
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Link to Immunological Reviews pdf: http://discovery.ucl.ac.uk/1417386/1/imr12114.pdf


The importance of the cytoskeleton in mounting a successful immune response is evident from the wide range of defects that occur in actin-related primary immunodeficiencies (PIDs). Studies of these PIDs have revealed a pivotal role for the actin cytoskeleton in almost all stages of immune system function, from hematopoiesis and immune cell development, through to recruitment, migration, intercellular and intracellular signaling, and activation of both innate and adaptive immune responses. The major focus of this review is the immune defects that result from mutations in the Wiskott-Aldrich syndrome gene (WAS), which have a broad impact on many different processes and give rise to clinically heterogeneous immunodeficiencies. We also discuss other related genetic defects and the possibility of identifying new genetic causes of cytoskeletal immunodeficiency.

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PLOS ONE: Interferon Signature in the Blood in Inflammatory Common Variable Immune Deficiency

PLOS ONE: Interferon Signature in the Blood in Inflammatory Common Variable Immune Deficiency | Immunopathology & Immunotherapy | Scoop.it
PLOS ONE: an inclusive, peer-reviewed, open-access resource from the PUBLIC LIBRARY OF SCIENCE. Reports of well-performed scientific studies from all disciplines freely available to the whole world.
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About half of all subjects with common variable immune deficiency (CVID) are afflicted with inflammatory complications including hematologic autoimmunity, granulomatous infiltrations, interstitial lung disease, lymphoid hyperplasia and/or gastrointestinal inflammatory disease. The pathogenesis of these conditions is poorly understood but singly and in aggregate, these lead to significantly increased (11 fold) morbidity and mortality, not experienced by CVID subjects without these complications. To explore the dysregulated networks in these subjects, we applied whole blood transcriptional profiling to 91 CVID subjects, 47 with inflammatory conditions and 44 without, in comparison to subjects with XLA and healthy controls. As compared to other CVID subjects, males with XLA or healthy controls, the signature of CVID subjects with inflammatory complications was distinguished by a marked up-regulation of IFN responsive genes. Chronic up-regulation of IFN pathways is known to occur in autoimmune disease due to activation of TLRs and other still unclarified cytoplasmic sensors. As subjects with inflammatory complications were also more likely to be lymphopenic, have reduced B cell numbers, and a greater reduction of B, T and plasma cell networks, we suggest that more impaired adaptive immunity in these subjects may lead to chronic activation of innate IFN pathways in response to environmental antigens. The unbiased use of whole blood transcriptome analysis may provides a tool for distinguishing CVID subjects who are at risk for increased morbidity and earlier mortality. As more effective therapeutic options are developed, whole blood transcriptome analyses could also provide an efficient means of monitoring the effects of treatment of the inflammatory phenotype.

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Human syndromes of immunodeficiency and dysregulation are characterized by distinct defects in T-cell receptor repertoire development

Human syndromes of immunodeficiency and dysregulation are characterized by distinct defects in T-cell receptor repertoire development | Immunopathology & Immunotherapy | Scoop.it
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The Journal of Allergy and Clinical ImmunologyConclusions

High-throughput TCR sequencing of rare immune disorders has demonstrated that quantitative TCR diversity can appear normal despite qualitative changes in repertoire and strongly suggests that in human subjects RAG enzymatic function might be necessary for normal CDR3 junctional diversity.

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Mutation in NFKB2 gene causes hard-to-diagnose immunodeficiency disorder CVID

Mutation in NFKB2 gene causes hard-to-diagnose immunodeficiency disorder CVID | Immunopathology & Immunotherapy | Scoop.it
Researchers discovered that a mutation in the NFKB2 gene impairs a protein from functioning properly, which interferes with the body's ability to make antibodies and fight infection.
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Am J Hum Genet. 2013 Nov 7;93(5):812-24. doi: 10.1016/j.ajhg.2013.09.009. Epub 2013 Oct 17.Germline Mutations in NFKB2 Implicate the Noncanonical NF-κB Pathway in the Pathogenesis of Common Variable Immunodeficiency.Chen K, Coonrod EM, Kumánovics A, Franks ZF, Durtschi JD, Margraf RL, Wu W, Heikal NM, Augustine NH, Ridge PG, Hill HR, Jorde LB, Weyrich AS,Zimmerman GA, Gundlapalli AV, Bohnsack JF, Voelkerding KV. CONCLUSION:These findings describe germline mutations in NFKB2 and establish the noncanonical NF-κB signaling pathway as a genetic etiology for this primary immunodeficiency syndrome.

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Traces Of HIV Found In Blood Of Previously 'Cured' Patients

Traces Of HIV Found In Blood Of Previously 'Cured' Patients | Immunopathology & Immunotherapy | Scoop.it
RedOrbit
Traces Of HIV Found In Blood Of Previously 'Cured' Patients
RedOrbit
In July, the two patients tested negative for the immunodeficiency virus. Now, however, Brigham and Women's Hospital associate professor of infectious diseases Dr.
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Both patients had been suffering from the blood cancer Hodgkin’s lymphoma, and after other cancer treatments had proven unsuccessful, the doctors transplanted healthy bone marrow into the patients. The hope was the transplant would help purge cancerous blood cells in favor of healthy cells, but the dangerous procedure involved a weakening of the immune system and carried with it a 15 to 20 percent chance of death.
Read more at http://www.redorbit.com/news/health/1113022668/hiv-aids-virus-cure-bone-marrow-transplant-120813/#5rv70JlRX8eWFD2S.99

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The altered landscape of the human skin microbiome in patients with primary immunodeficiencies

The altered landscape of the human skin microbiome in patients with primary immunodeficiencies | Immunopathology & Immunotherapy | Scoop.it

This study examines differences in microbial colonization and community stability in PID skin and informs our understanding of host–microbiome interactions, suggesting a bidirectional dialogue between skin commensals and the host organism.

Alfredo Corell's insight:

The altered landscape of the human skin microbiome in patients with primary immunodeficienciesJulia Oh1, Alexandra F. Freeman2, NISC Comparative Sequencing Program3, Morgan Park3, Robert Sokolic1, Fabio Candotti1,Steven M. Holland2, Julia A. Segre1,5,6 and Heidi H. Kong4,5,6Article published online before print. Article, supplemental material, and publication date are athttp://www.genome.org/cgi/doi/10.1101/gr.159467.113.

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Natural killer cell deficiency

Natural killer cell deficiency | Immunopathology & Immunotherapy | Scoop.it
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The Journal of Allergy and Clinical Immunology
Volume 132, Issue 3 , Pages 515-525, September 2013Natural killer cell deficiencyJordan S. Orange, MD, PhD


Natural killer (NK) cells are part of the innate immune defense against infection and cancer and are especially useful in combating certain viral pathogens. The utility of NK cells in human health has been underscored by a growing number of persons who are deficient in NK cells and/or their functions. This can be in the context of a broader genetically defined congenital immunodeficiency, of which there are more than 40 presently known to impair NK cells. However, the abnormality of NK cells in certain cases represents the majority immunologic defect. In aggregate, these conditions are termed NK cell deficiency. Recent advances have added clarity to this diagnosis and identified defects in 3 genes that can cause NK cell deficiency, as well as some of the underlying biology. Appropriate consideration of these diagnoses and patients raises the potential for rational therapeutic options and further innovation.

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March 27 wear Yellow to support Boy with SCID

March 27 wear Yellow to support Boy with SCID | Immunopathology & Immunotherapy | Scoop.it

A 5-year-old boy confined to a hospital room due to SCID (a rare immune disorder) is asking people to wear yellow in a show of support before his next operation — and the response on social media has been overwhelming, his family says.

Alfredo Corell's insight:

He asked supporters to wear his favorite color on March 27, before he undergoes a second bone marrow operation, and post the photos online with the hashtag #WearYellowForSeth. Seth’s family, from Northamptonshire, England, has been chronicling his time at the hospital on their blog, “Our Little Hero.” 

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CDC e-HAP FYI Updates: National Gay Mens's HIV/AIDS Awareness Day

CDC e-HAP FYI Updates: National Gay Mens's HIV/AIDS Awareness Day | Immunopathology & Immunotherapy | Scoop.it
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  •  Reasons/Razones is a bilingual campaign that encourages HIV testing among Latino gay and bisexual men.
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Newborn Screening for Severe Combined Immunodeficiency

Newborn Screening for Severe Combined Immunodeficiency | Immunopathology & Immunotherapy | Scoop.it
Opinion from JAMA — Newborn Screening for Severe Combined Immunodeficiency — Progress and Challenges (RT @JAMA_current: #Newborn Screening for Severe Combined #Immunodeficiency http://t.co/opTP3izQBP...
Alfredo Corell's insight:

September 30, 2014, marks the 50th anniversary of the Children’s Bureau recommendation for “the screening of all newborn infants for PKU [phenylketonuria] on a routine basis.”1 By 1968, 43 states had made screening for PKU mandatory.1 As a result of technological advances, newborn screening in the United States has been extended to as many as 37 core conditions in some states.2 As reported by Kwan and colleagues3 in this issue of JAMA, newborn screening for severe combined immunodeficiency (SCID) has been undertaken in 23 states and the Navajo Nation, beginning in Wisconsin in January 2008. The authors present data on more than 3 million newborns screened with a T-cell receptor excision circle (TREC) assay followed by confirmatory flow cytometry from 11 of these programs (10 states and the Navajo Nation).

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Patients with Primary Immunodeficiencies in Pediatric Intensive Care Unit: Outcomes and Mortality-Related Risk Factors

Patients with Primary Immunodeficiencies in Pediatric Intensive Care Unit: Outcomes and Mortality-Related Risk Factors | Immunopathology & Immunotherapy | Scoop.it
RT @Primary_Immune: Patients with Primary #Immunodeficiency in Pediatric ICUs: Risk, Outcomes & Mortality http://t.co/5M6TDf3cXt … #immun…
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Conclusions

This is the first study regarding the outcome and mortality-related risk factors for PID patients requiring PICU admission. We suggest that PICU management is as important as early diagnosis and treatment for these patients. Prediction of those at risk for poorer outcome might be beneficial for accurate intensive care management and survival.

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Common Variable Immune Deficiency (CVID) | atypically found in an adult

Common Variable Immune Deficiency (CVID) | atypically found in an adult | Immunopathology & Immunotherapy | Scoop.it
Find information on Common Variable Immune Deficiency (CVID), including definition, diagnosis, treatment, and expectations for patients.
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An atypically adult with CVID recently published on "The Lancet"


The Lancet, Volume 383, Issue 9920, Page 926, 8 March 2014
doi:10.1016/S0140-6736(14)60415-3Cite or Link Using DOI
Common variable immunodeficiency syndrome in an adult
Dr Laura S Lourdes MD a Karen C Daily DO b
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The PedPAD study: Boys predominate in the hypogammaglobulinemia registry of the ESID Online Database

The PedPAD study: Boys predominate in the hypogammaglobulinemia registry of the ESID Online Database | Immunopathology & Immunotherapy | Scoop.it
New Research Article Hints At Mysterious X-Linked Version of Common Variable #Immunodeficiency (#CVID) http://t.co/ksEBcYmorK #Immunology
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The most striking observation is the strong majority of male patients in the group of children with primary hypogammaglobulinemia (n=1292, 63%). This male predominance was observed in each of the 18 countries involved. The boys were younger at diagnosis (mean age males 5.3 years; mean age females 5.8 years). Moreover, one or more complications were more frequently reported in boys (12%) as compared to girls (5%). The male predominance suggests that patients with an undetected or unknown X-linked genetic cause are included in this group of children registered as primary hypogammaglobulinemia.

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New hopes: Immunotherapy for HIV Infection?

New hopes: Immunotherapy for HIV Infection? | Immunopathology & Immunotherapy | Scoop.it
Clinical Implications of Basic Research from The New England Journal of Medicine — Immunotherapy for HIV Infection.
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Immunotherapy for HIV Infection

Robin A. Weiss, Ph.D.

N Engl J Med 2014; 370:379-380January 23, 2014DOI: 10.1056/NEJMcibr1314577

Two recent studies show that a hybrid virus, the simian immunodeficiency virus bearing the envelope antigens of HIV-1, can be cleared from the blood of rhesus macaques by the infusion of monoclonal antibodies.

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New diagnostic criteria for common variable immune deficiency (CVID), which may assist with decisions to treat with intravenous or subcutaneous immunoglobulin

New diagnostic criteria for common variable immune deficiency (CVID), which may assist with decisions to treat with intravenous or subcutaneous immunoglobulin | Immunopathology & Immunotherapy | Scoop.it
#Immunology: New Diagnostic Criteria for Common Variable Immunodeficiency (#CVID): IV or SubQ #Immunoglobulin? http://t.co/hQSMeiFj8y … #PI
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Summary

Common variable immune deficiency (CVID) is the most frequent symptomatic primary immune deficiency in adults. The standard of care is intravenous immunoglobulin (IVIG) or subcutaneous immunoglobulin (scIG) therapy. The cause of CVID is currently unknown, and there is no universally accepted definition of CVID. This creates problems in determining which patients will benefit from IVIG/scIG treatment. In this paper, we review the difficulties with the commonly used European Society of Immune Deficiencies (ESID) and the Pan American Group for Immune Deficiency (PAGID) definition of CVID. We propose new criteria for the diagnosis of CVID, which are based on recent scientific discoveries. Improved diagnostic precision will assist with treatment decisions including IVIG/scIG replacement. We suggest that asymptomatic patients with mild hypogammaglobulinaemia are termed hypogammaglobulinaemia of uncertain significance (HGUS). These patients require long-term follow-up, as some will evolve into CVID.

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Tregitope Peptides: The Active Pharmaceutical Ingredient of IVIG?

Tregitope Peptides: The Active Pharmaceutical Ingredient of IVIG? | Immunopathology & Immunotherapy | Scoop.it

Tregitope applications may include any of the autoimmune diseases that are currently treated almost exclusively with intravenous immunoglobulin G (IVIG), such as Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Multifocal Motor Neuropathy (MMN), as well as gene therapy and allergy where Tregitopes may provide a means of inducing antigen-specific tolerance.

Alfredo Corell's insight:

Link to the journal: http://www.hindawi.com/journals/jir/2013/493138/

Download pdf: http://downloads.hindawi.com/journals/cdi/2013/493138.pdf

 

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International Gene Therapy Trial for 'Bubble Boy' Disease Shows Promising early results.

International Gene Therapy Trial for 'Bubble Boy' Disease Shows Promising early results. | Immunopathology & Immunotherapy | Scoop.it
San Francisco Chronicle
International Gene Therapy Trial for 'Bubble Boy' Disease Shows Promising ...
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Eight of the nine boys registered to date in the new trial are alive and well, with functioning immune systems and free of infections associated with SCID-X1, between nine and 36 months following treatment, according to Sung-Yun Pai, MD, a pediatric hematologist-oncologist from Dana-Farber/Boston Children's Cancer and Blood Disorders Center. She presented the findings at the 55th annual meeting of the American Society of Hematology on behalf of the Transatlantic Gene Therapy Consortium (TAGTC). The investigators continue to monitor the children for signs of treatment-associated leukemia, which developed three to five years post-treatment in the prior trial. They point to surrogate biological markers that give them hope the viral vector used to deliver the new treatment is safe.

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Molecular interplay explains many immunodeficiencies

Molecular interplay explains many immunodeficiencies | Immunopathology & Immunotherapy | Scoop.it

Australian scientists have described an exquisitely balanced interplay of four molecules that trigger and govern antibody production in immune cells.

As well as being an important basic science discovery, it helps explain why people with mutations in any one of the associated genes cannot fight infection effectively, and develop rare and crippling immunodeficiency disorders.

Alfredo Corell's insight:

Link to the Blood Journal:

http://bloodjournal.hematologylibrary.org/content/early/2013/10/24/blood-2013-06-506865.full.pdf?hw-tma-check=true

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Major setback for AIDS cure: Study finds reservoir of hidden HIV bigger than once thought

Major setback for AIDS cure: Study finds reservoir of hidden HIV bigger than once thought | Immunopathology & Immunotherapy | Scoop.it
Over the past decade, scientists have made incredible strides in the field of HIV research, but a cure for the human immunodeficiency virus has still eluded scientists.
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These findings mean that scientists have many more proviruses to kill in order to fully cure an individual of HIV.  However, Siliciano hopes his research will dissuade patients from entering into clinical trials testing a “shock and kill” approach to curing the virus, which involves activating many of the body’s T cells to force the proviruses to activate.  Since the size of the provirus reservoir is so large, Siliciano said this technique could lead to major damage in the body.


The paper in "Cell": http://www.cell.com/abstract/S0092-8674(13)01157-4 ;

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