Dissertations / Theses on the topic 'Intravenous Immunoglobulin'
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Das, Mrinmoy. "The regulatory effects of circulating normal immunoglobulins on autophagy and Th17 response." Thesis, Paris 6, 2017. http://www.theses.fr/2017PA066153/document.
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Les immunoglobulines circulantes jouent un rôle critique dans l’homéostasie immune en modulant les fonctions des cellules du système immunitaire. Au cours de ma thèse, j’ai exploré les effets régulateurs des immunoglobulines G thérapeutiques (IVIG) et des immunoglobulines A monomériques circulantes (mIgA) sur l’autophagie et les réponses Th17 respectivement. Les IVIg sont une préparation thérapeutique d’IgG normales poolées. Elles ont utilisées comme agent anti-inflammatoire dans le traitement de maladies auto-immunes et inflammatoires variées. Cependant, les mécanismes ne sont pas complètement élucidés et plusieurs mécanismes mutuels et non exclusifs ont été proposés. L’autophagie est un important processus biologique impliquant la dégradation lysosomale des composants cellulaires endommagés et des protéines mal repliées. Il y a plusieurs preuves montrant l’implication de l’autophagie dans les maladies auto-immunes et auto-inflammatoires incluant la découverte de polymorphismes dans des gènes liés à l’autophagie. J’ai montré que l’induction de l’autophagie par les IVIG représente un nouveau mécanisme d’action permettant leur effet thérapeutique dans les maladies auto-immunes et inflammatoires. Les Th17 représentent une cible attractive pour traiter plusieurs maladies inflammatoires et auto-immunes. Malgré le fait qu’elles sont le deuxième anticorps le plus abondant dans la circulation, la function immunorégulatrice des IgA n’est relativement pas explorée. J’ai montré que les IgA monomériques (mIgA) inhibent la différentiation et l’amplification des cellules Th17 humaines et la production de leur cytokine effectrice IL-17ACirculating immunoglobulins play a critical role in the immune homeostasis by modulating the functions of immune cells. In my thesis, I investigated the regulatory effects of therapeutic immunoglobulin G (IVIG) and circulating monomeric immunoglobulin A (mIgA) on autophagy and human Th17 response respectively. IVIG is a therapeutic preparation of pooled normal IgG. It is used as an anti-inflammatory agent in the treatment of a wide variety of autoimmune and inflammatory diseases. However, the mechanisms are not yet fully elucidated and several mutually non-exclusive mechanisms have been proposed. Autophagy is an important biological process involving lysosomal degradation of damaged cellular components and misfolded proteins. There are several evidences that support the involvement of autophagy in autoimmune and auto- inflammatory disorders including the discovery of polymorphisms in autophagy-related genes. I show that induction of autophagy by IVIG represents a novel mechanism of action in achieving therapeutic effect in autoimmune and inflammatory diseases. Th17 cells represent an attractive target to treat several inflammatory and autoimmune diseases. Despite being second most abundant antibody in the circulation, the immunoregulatory function of IgA is relatively unexplored. I have shown that monomeric IgA (mIgA) inhibits differentiation and amplification of human Th17 cells and the production of their effector cytokine IL-17A
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Bilal, Jawad, Irbaz B. Riaz, Jennifer L. Hill, and Tirdad T. Zangeneh. "Intravenous Immunoglobulin-Induced Pulmonary Embolism: It Is Time to Act!" LIPPINCOTT WILLIAMS & WILKINS, 2016. http://hdl.handle.net/10150/620829.
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Pulmonary embolism (PE) is a common clinical problem affecting 600,000 patients per year in the United States. Although the diagnosis can be easily confirmed by imaging techniques, such as computed tomographic angiography of the chest, the identification of underlying mechanism leading to PE is important for appropriate duration of anticoagulation, and prevention of subsequent episodes. The differential diagnosis of underlying mechanism is broad and must include careful review of medication history. Drug-related thromboembolic disease can be easily missed and may have catastrophic consequences. The identification of the culprit drug is important for prevention of subsequent episodes and choosing appropriate duration of anticoagulation. We report a case of a middle-aged man who developed PE after administration of intravenous immunoglobulin.
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Pain, Elisabeth. "Investigation of the immunomodulatory properties of intravenous immunoglobulin G (IVIg)." Thesis, University of Bristol, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251131.
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Lam, Shang Leen Clifford. "Plasma procurement and clinical evaluation of an intravenous immunoglobulin preparation." Thesis, University of Edinburgh, 1987. http://hdl.handle.net/1842/19028.
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Taylor, Rosemary. "Clinical Practice Guidelines for Home Management of Intravenous Immunoglobulin Therapy." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7342.
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The infusion of intravenous immunoglobulin therapy in the home setting requires a critical nursing assessment and interventions aimed at managing and preventing the escalation of adverse events. Some patients experience side effects that necessitate a rapid response by field nurses, requiring standing orders for nursing administration and the availability of essential medications to alleviate symptoms in the patient's home. The clinical practice issue was that the home health agency did not have a uniform clinical practice nursing guideline to assist field nurses in providing rapid responses for managing infusion-related reactions. The purpose of this project was to develop an evidence-based clinical practice guideline using standing orders for the comprehensive management of immunoglobulin side effects in the patient's home. The practice-focused question centered on whether the use of a nursing practice guideline based on interprofessional collaboration could manage the side effects of patients in the home by decreasing the use of emergent care and improved quality of care for those patients susceptible to significant side effects. An interdisciplinary expert panel experience in IVIG l used Newman's system theory and the reach, effectiveness, adoption, implementation, maintenance framework for interprofessional collaboration in developing a clinical nursing guideline with a standing order for rating side effects. Panelists used the appraisal of guidelines, research, and evaluation II tool to appraise the evidence for the guideline. The use of clinical guideline with standing orders to address the needs of patients in the home setting may lead to positive social change by enabling more rapid management of symptoms, more effective care in the home, and improved patient outcomes
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Lin, Hsin Hsin. "Mechanisms of Intravenous Immunoglobulin in the Treatment of Experimental Autoimmune Neuritis." University of Sydney, 2007. http://hdl.handle.net/2123/1696.
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PhDThe aims of this study were to test the efficacy of immunoglobulin and its Fab and Fc fragment in the treatment of experimental autoimmune neuritis (EAN) in Lewis rats, to investigate which portion of immunoglobulin is operative in the effect of IVIg, and to clarify the possible mechanisms by which immunoglobulin exerts its action in the treatment of rats EAN. EAN was induced by immunization with whole bovine peripheral nerve myelin. The immunized rats were randomized into groups, assessed clinically, electrophysiologically, and histologically, and intravenously injected with normal saline, albumin, human IVIg preparation, purified Fab or Fc fragments. The treatment efficacy was compared between normal saline and albumin groups, albumin and IVIg groups, albumin and Fab groups, albumin and Fc groups, Fab and Fc groups, Fab and IVIg groups, and Fc and IVIg groups. Methods of myelin isolation, antibody purification, and Western blot techniques were also applied. The results revealed that treatment with Fc fragment and IVIg at the onset of signs of disease effectively prevented further progression of disease, shortened disease duration, and facilitating recovery from illness as shown in clinical, electrophysiological and histological parameters. In the study which the efficacy of albumin and IVIg was compared, 5 out of 17 rats (29%) in the albumin group and 12 out of 17 (71%) in the IVIg group completely recovered from the clinical disease by day 30. The animals receiving IVIg treatment exhibited lower clinical scores, less prolongation of S wave latencies, better maintained S wave amplitudes, less reduction of distal motor NCVs, better maintained distal and proximal CMAP amplitudes, and lower histological grades. In the study which the efficacy of albumin, Fab fragment, Fc fragment, and IVIg was compared, 0 out of 8 (0%) in the albumin group, 1 out of 8 (13%) in the Fab group, 4 out of 8 (50%) in the Fc group, and 6 out of 9 (67%) rats in the IgG group completely recovered from the clinical disease by day 30. The animals receiving Fc fragment and IVIg treatment exhibited lower clinical scores, less prominent weight loss, less prolongation of S wave latencies, better maintained S wave amplitudes, less reduction of distal motor NCVs, better maintained distal and proximal CMAP amplitudes, and lower histological grades.
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Lin, Hsin Hsin. "Mechanisms of Intravenous Immunoglobulin in the Treatment of Experimental Autoimmune Neuritis." Thesis, The University of Sydney, 2006. http://hdl.handle.net/2123/1696.
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The aims of this study were to test the efficacy of immunoglobulin and its Fab and Fc fragment in the treatment of experimental autoimmune neuritis (EAN) in Lewis rats, to investigate which portion of immunoglobulin is operative in the effect of IVIg, and to clarify the possible mechanisms by which immunoglobulin exerts its action in the treatment of rats EAN. EAN was induced by immunization with whole bovine peripheral nerve myelin. The immunized rats were randomized into groups, assessed clinically, electrophysiologically, and histologically, and intravenously injected with normal saline, albumin, human IVIg preparation, purified Fab or Fc fragments. The treatment efficacy was compared between normal saline and albumin groups, albumin and IVIg groups, albumin and Fab groups, albumin and Fc groups, Fab and Fc groups, Fab and IVIg groups, and Fc and IVIg groups. Methods of myelin isolation, antibody purification, and Western blot techniques were also applied. The results revealed that treatment with Fc fragment and IVIg at the onset of signs of disease effectively prevented further progression of disease, shortened disease duration, and facilitating recovery from illness as shown in clinical, electrophysiological and histological parameters. In the study which the efficacy of albumin and IVIg was compared, 5 out of 17 rats (29%) in the albumin group and 12 out of 17 (71%) in the IVIg group completely recovered from the clinical disease by day 30. The animals receiving IVIg treatment exhibited lower clinical scores, less prolongation of S wave latencies, better maintained S wave amplitudes, less reduction of distal motor NCVs, better maintained distal and proximal CMAP amplitudes, and lower histological grades. In the study which the efficacy of albumin, Fab fragment, Fc fragment, and IVIg was compared, 0 out of 8 (0%) in the albumin group, 1 out of 8 (13%) in the Fab group, 4 out of 8 (50%) in the Fc group, and 6 out of 9 (67%) rats in the IgG group completely recovered from the clinical disease by day 30. The animals receiving Fc fragment and IVIg treatment exhibited lower clinical scores, less prominent weight loss, less prolongation of S wave latencies, better maintained S wave amplitudes, less reduction of distal motor NCVs, better maintained distal and proximal CMAP amplitudes, and lower histological grades.
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Miyakoshi, Chisato. "Heart Rate, Responsiveness to Intravenous Immunoglobulin, and Coronary Artery Aneurysms in Kawasaki Disease." Kyoto University, 2019. http://hdl.handle.net/2433/236617.
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Yu, Xiaojie. "Immunomodulatory properties of IgG glycosylation and the anti-inflammatory mechanism of intravenous immunoglobulin." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:140048b3-7cf4-4a30-932b-59c3e1d20272.
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The IgG Fc domain mediates a range of antibody effector functions, including antibody dependent cell-mediated cytotoxicity (ADCC), complement activation, phagocytosis, and the recently emerged general anti-inflammatory effect of immunoglobulin therapy (IVIg). The conserved N-glycan attached to Fc N297 maintains the Fc structural integrity for the effector functions, while its glycoform is known to modulate the affinity for the Fc γ-receptors (FcγRs), complement, and the C-type lectin DC-SIGN. IgG Fc exhibits protein-directed glycosylation characterized by a series of biantennary complex type glycoforms, with a small population of sialylated species. The sialylated Fc has been proposed to bind DC-SIGN and initiate an anti-inflammatory signalling pathway. The restricted Fc glycan processing is partially attributed to the hydrophobic interaction between Fc glycan and the hydrophobic Fc protein backbone. Mutations within the hydrophobic Fc protein-glycan interface dramatically increases Fc glycan processing, while concomitantly decreases Fc affinity for the FcγRs. However, it is unclear whether this disrupted Fc-FcγR interaction was due to the increased terminal glycan processing, or the perturbed Fc protein-glycan interface. Here, the integrity of the Fc protein-glycan interface was demonstrated to be important in maintaining the productive Fc-FcγR interaction independently of glycoform. This glycoform-independent effect was exploited to generate novel inhibitory Fc variants. In addition, the interaction between sialylated IgG and the putative IVIg receptor DC-SIGN was re-evaluated. Analysis shows that IVIg binds DC-SIGN in a glycan-independent, Fab-mediated manner. Furthermore, the effect of IVIg sialylation on human antigen presenting cells was examined; evidence presented here indicate that IVIg deglycosylation, not desialylation, has an anti-inflammatory effect on human dendritic cells (DCs). These data suggest the need for a general re-evaluation of the current mechanistic model of anti-inflammatory IVIg.
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Klaesson, Sven. "Immune modulatory effects of intravenous immunoglobulin in vitro and after allogeneic bone marrow transplantation /." Stockholm, 1997. http://diss.kib.ki.se/1997/91-628-2636-0.
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Ihara(Ito), Toshiko. "Clinical efficacy of intravenous immunoglobulin for patients with MPO-ANCA-associated rapidly progressive glomerulonephritis." Kyoto University, 2005. http://hdl.handle.net/2433/144378.
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Skansén-Saphir, Ulrika. "Immunomodulation by intravenous immunoglobulin : the effect on cytokine production studied at the single-cell level /." Stockholm, 1998. http://diss.kib.ki.se/search/diss.se.cfm?19981023skan.
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Imholz, Beat. "Intravenous immunoglobulin (i.v. IgG) for pretreated acute and chronic idiopathic thrombocytopenic purpura (ITP) in childhood /." [S.l : s.n.], 1986. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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Iro, Mildred. "Childhood encephalitis in the United Kingdom : epidemiology, trends in hospital admissions and the role of intravenous immunoglobulin." Thesis, University of Oxford, 2018. http://ora.ox.ac.uk/objects/uuid:cd740365-b233-4917-bb30-f19d28ff21a4.
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The burden from childhood encephalitis is significant, 30-60% of affected children develop long term disability despite treatment. Crucial to improving outcomes are a better understanding of the disease epidemiology, and the identification of alternative treatment strategies. To contribute to ongoing work currently addressing these issues globally, I conducted a 30-year review of childhood encephalitis hospital admissions in England, and also a 10- year review of paediatric intensive care unit (PICU) admissions in England and Wales (E&W). Through these projects, I defined the incidence of all-cause childhood encephalitis in England, and severe encephalitis in E&W. I described hospital admission trends for childhood encephalitis in England, and evaluated how these had varied with introduction of the combined measles, mumps, rubella vaccine. Furthermore, I estimated the potential cost burden from encephalitis PICU admissions, and identified factors associated with mortality and length of stay on PICU in children with severe encephalitis. This thesis provides high quality data from a Cochrane systematic review on the role of intravenous immunoglobulin (IVIG) treatment in childhood encephalitis, and describes the initiation of the first ever randomised controlled trial (RCT) of IVIG all-cause childhood encephalitis (IgNITE). The incidence for all-cause childhood encephalitis in England was between 2.91/100,000/year (95%CI 2.80-3.14) and 4.02/100,000/year (3.80-4.28), and the incidence of severe childhood encephalitis in E&W was 0.79/100,000/year (0.74-0.84). An increasing trend in encephalitis admissions was observed between 1999-2011, compared to the previous years. This increase was most marked in infants, and mostly seen in the 'encephalitis of unknown aetiology' group. Measles and mumps encephalitis admissions reduced by 30-fold after the two dose MMR vaccination schedule was introduced, compared with the pre MMR period. The PICU encephalitis bed cost was £414,000/year. The Cochrane review revealed paucity of RCTs of IVIG in encephalitis. Although the findings indicated some benefit from IVIG, the quality of the evidence was very low. Accordingly, I initiated the first ever RCT of IVIG treatment in all-cause childhood encephalitis, which had recruited 18 participants from 21 sites. Data from an interim analysis of this cohort showed that 60% were admitted to PICU, and 89% required invasive ventilation. Also, 80% of affected children had persisting symptoms at hospital discharge, 67% made poor recovery at 4-8 weeks after hospital discharge while 42% and 30% made poor recovery at 6 and 12 months follow up, respectively. The increasing trend in childhood encephalitis admissions in the context of the ongoing threat from emerging and reemerging pathogens, indicates the need for continued disease surveillance. The findings of the systematic review rationalise the need for the IgNiTE study. The results of the interim analysis of data from the IgNiTE trial indicate the need to identify strategies to improve outcomes in children with encephalitis. It is anticipated that the IgNiTE trial would yield results that could alter the way that children with encephalitis are managed.
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Ihendyane, Nahla. "Pathogenesis and immunotherapy of streptococcal septicemia and shock /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-599-9/.
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Cooper, Ryan. "Intravenous Immunoglobulin Use in the Treatment of Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome: A 10-year Retrospective Analysis of Patients of a Single Burn Center." Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/315845.
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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.Stevens - Johnson syndrome and Toxic Epidermal Necrolysis Syndrome are rare, but serious conditions affecting skin and mucous membranes that are primarily treated with supportive care. Other more specific therapies have limited evidence to support the benefit of their use; one such treatment is intravenous immunoglobulin (IVIG). The use of IVIG in the treatment of these syndromes remain controversial due to mixed results demonstrated in the literature, and at present is not considered a component of the standard of care. This study seeks to provide additional data regarding the efficacy of IVIG treatment on mortality in a small cohort of patients presenting with these syndromes at a regional burn center over a 10-year period; data was retrospectively collected from patient medical records. On analysis of this data, IVIG use showed a potential, but not significant. improvement on mortality in comparison to the non-treatment group. Compared with the non-treatment group, odds ratios for death were 0.81 (95% CI 0.3-2.0) for IVIG. There is ultimately no new evidence that the benefit of IVIG in the treatment of Stevens - Johnson syndrome and Toxic Epidermal Necrolysis Syndrome is anything more than potential. Further investigation should include a rigorous analysis and comparison of different dosing regimens.
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Gennari, Pamela Jane. "The Role of Illness Intrusiveness and Personal Control in Mediating the Relationship between the Intravenous Immunoglobulin Treatment Experience and Quality of Life in Neurological Autoimmune Patients." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2286.
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Intravenous immunoglobulin (IVIG) is a common treatment for the neurological autoimmune diseases multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. However, there is scant literature regarding the psychological effects of this treatment on quality of life (QOL). Using illness intrusiveness theory and personal control theory, this correlational, cross-sectional study examined the relationship between the IVIG treatment experience and QOL in neurological autoimmune patients. Surveys were employed to collect data from 79 patients at a neurological infusion center in Phoenix, AZ. Quantitative analyses included correlation, multiple regression, and mediation analyses to determine whether (a) IVIG treatment experience predicted QOL measured by 10 Neuro-QOL scales, (b) illness intrusiveness mediated the relationship between IVIG treatment experience and QOL, and (c) personal control mediated the relationship between illness intrusiveness and QOL. IVIG treatment experience predicted QOL in 1 Neuro-QOL subscale; illness intrusiveness mediated 9 of the Neuro-QOL subscales using bias-corrected bootstrapping for statistical significance; and personal control did not mediate the relationship between illness intrusiveness and QOL. These results may affect social change by increasing the understanding of physicians, nurses, and patients regarding the psychosocial impact of IVIG treatment. Results from the study may provide insight for interventions to assist patients in adjusting to this form of treatment.
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Galeotti, Caroline. "Effets des immunoglobulines intraveineuses sur les cellules de l'immunité innée." Thesis, Sorbonne université, 2018. http://www.theses.fr/2018SORUS054.
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Les IgIV, une préparation thérapeutique d'IgG normales, sont utilisées dans le traitement de diverses maladies auto-immunes et inflammatoires. Les mécanismes par lesquels les IgIV exercent une activité anti-inflammatoire ne sont pas complètement compris. Elles interagissent avec de nombreux composants du système immunitaire et modulent leurs fonctions. Des études récentes ont rapporté que l'hème oxygénase-1 (HO-1) joue un rôle important dans la régulation de la réponse inflammatoire dans un certain nombre de pathologies. Plusieurs agents thérapeutiques exercent des effets anti-inflammatoires grâce à l'induction de l'HO-1. Etant donné le rôle commun anti-inflammatoire de l'HO-1 et des IgIV, j'ai étudié l'implication de l'HO-1 dans les mécanismes d'action des IgIV. J'ai montré que les effets des IgIV ne sont pas associés à l'induction de l'HO-1, que ce soit dans des cellules de l'immunité innée comme les monocytes, cellules dendritiques ou macrophages, ou dans les reins et foie de souris avec une encéphalomyélite auto-immune expérimentale traitées par les IgIV. Des données récentes dans des modèles expérimentaux suggèrent que les IgIV induisent la sécrétion d’IL-4 des basophiles en augmentant l’IL-33 des cellules innées SIGN-R1+. J’ai rapporté que les IgIV induisent directement l’activation de basophiles pré-stimulés avec l’IL-3 alors que contrairement au modèle murin, l’IL-33 n’est pas indispensable. L’activation des basophiles par les IgIV est associée à l’expression augmentée de CD69 et la sécrétion d’IL-4, d’IL-6 et d’IL-8. Ces fonctions sont médiées par les fragments F(ab’)2 qui se lient à des IgE membranaires et activent la voie SykIntravenous immunoglobulin (IVIG), a therapeutic normal immunoglobulin G preparation, is used in the therapy of various autoimmune and inflammatory conditions. The mechanisms by which IVIG exerts anti-inflammatory effects are not completely understood. It interacts with numerous components of the immune system including dendritic cells, macrophages, T and B cells and modulates their functions. Recent studies have reported that heme oxygenase-1 (HO-1) pathway plays an important role in the regulation of inflammatory response in several pathologies. Several therapeutic agents exert anti-inflammatory effects via induction of HO-1. Therefore, in view of common anti-inflammatory role exerted by both HO-1 and IVIG, I investigated if mechanisms of IVIG implicate HO-1. I show that anti-inflammatory effects of IVIG were not associated with an induction of HO-1 either in innate cells such as monocytes, dendritic cells and macrophages or in the kidneys or liver of experimental autoimmune encephalomyelitis. Recent data in experimental models suggest that IVIG induces IL-4 in basophils by enhancing IL-33 in SIGN-R1+ innate cells. I reported that IVIG directly induces activation of IL-3-primed basophils while unlike mice IL-33 was dispensable. The activation of basophils by IVIG was associated with enhanced expression of CD69 and secretion of IL-4, IL-6 and IL-8. These functions of IVIG are mediated via F(ab’)2 fragments that bind to basophil surface IgE and activate Syk pathway
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Britto, Alexandre Paulo Machado de. "Custo-efetividade do uso de imunoglobulina intravenosa e de plasmaferese no tratamento da síndrome de Guillain-Barré no Hospital de Clínicas de Porto Alegre." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/148859.
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Objetivo: Comparar as relações de custo-efetividade de duas terapias, Imunoglubulina Intravenosa (IgIV) e Plasmaferese (PE), no tratamento da Síndrome de Guillain-Barré sob a perspectiva do sistema público (SUS). O objetivo secundário foi avaliar a adesão às recomendações da Comissão de Medicamentos do HCPA Métodos: estudo transversal com análise econômica de pacientes tratados por Síndrome de Guillain-Barré no período de junho de 2003 a junho de 2008 no Hospital de Clínicas de Porto Alegre (HCPA). Foi realizada análise de custo-efetividade do emprego de IgIV e de PE nestes pacientes, pelo método de minimização de custos, considerando-se somente os custos diretos sanitários, fornecidos pelo sistema gerencial da instituição . Foram excluídos os pacientes que usaram outro tipo de tratamento associado ou isolado. Coletaram-se os dados através da revisão dos prontuários. A gravidade da doença na internação foi classificada como: doença leve, quando caminhar foi possível; doença moderada, quando caminhar foi impossível; doença grave, quando os pacientes necessitaram de ventilação assistida. A incapacidade na alta foi estabelecida pela escala de sete pontos de Hughes. A adesão às recomendações da Comissão de Medicamentos do HCPA, objetivo secundário, foi avaliada através da dose e o esquema de prescrição da IgIV. Resultados: Vinte e cinco participantes (2 a 70 anos) foram incluídos no estudo, cinco tratados com PE, empregando-se Albumina Humana como substituto do plasma, e 20 tratados com IgIV. O custo total do tratamento de um paciente com PE foi R$10.603,88 (± 2.978,12) e o de um que recebeu IgIV foi R$ 32.103,00 (± 21.454,24). O custo total da internação foi de R$45.027,14 (± 32.750,45) para os tratados com PE e de R$ 60.844,28 (±48.590,52) para os que receberam IgIV. Em relação ao desfecho clínico principal, melhora na escala de incapacidade de sete pontos, após o tratamento com uma das alternativas escolhida, a mediana dos pacientes que internaram com grau de gravidade 3 e que foram tratados com PE foi igual a dos que receberam IgIV. Em relação à permanência hospitalar, permanência em UTI e dias de Ventilação Mecânica, não houve diferença estatisticamente significativa entre os dois tratamentos. Conclusões: Quando comparados os custos médios das duas opções terapêuticas, uma delas aparece claramente com menor custo. Quando comparados os desfechos, após o emprego de cada opção terapêutica, estes não revelam diferença. Concluímos que, no HCPA, a opção pelo procedimento Plasmaferese é mais custo efetiva do que o emprego da IgIV.Objectives: To compare the cost-effectiveness of two distinct therapies, Intravenous Immunoglobulin (IVIg) and Plasma Exchange (PE) in the treatment of Guillain-Barré Syndrome, concerning the public health care system. Compliance to the guidelines of the Pharmacy and Therapeutics Committee of the Hospital de Clínicas de Porto Alegre was a secondary objective. Methods: A cross-sectional, economical analysis was conducted, including patients treated for GBS in the period from June, 2003 through June, 2008 in Hospital de Clínicas de Porto Alegre (HCPA). The cost-effectiveness of the use of IVIg and PE in such patients was studied through the cost minimization method, considering direct medical costs only (2008 currency), yield by the management of the institution. Patients receiving treatments other than PE or IVIg were excluded. Data were collected by chart reviews. Severity of disease on admittance was classified as follows: mild disease, when the patient was able to walk; moderate disease, when the patient was unable to walk, and severe disease, when assisted ventilation was required. Disability on discharge was established by the 7-point scale of Hughes. Compliance to the guidelines of the Pharmacy and Therapeutics Committee was evaluated through the dose and prescription scheme of IVIg. Results: Twenty-five participants (2 to 70 years of age) were included in the study, 5 were submitted to treatment with PE, using human albumin as replacement for plasma, and 20 were treated with IVIg. The total treatment cost for PE in a single patient was US$6,058.85 (±1,701.78 SD), and the same expense for IVIg was US$18,344.57 (± 12,259.56 SD) (p = 0.035). Total inpatient cost was US$25,729.79 (± 18,714.54 SD) in the PE group, and US$34,768.16 (±27,766.01 SD) (p=0.530) in the IVIg group. The main clinical outcome was improvement in the 7-point disability grade scale. The median of that measure in patients admitted with a severity grade 3 treated either with PE and IVIg was the same. Secondary outcomes, such as in-hospital stay, ICU stay, and number of days on mechanical ventilation revealed no statistically significant difference between treatments. Conclusions: As the mean expenses of both therapeutic options are compared, one clearly stands-out as less onerous. Clinical outcomes, when compared, reveal no statistical difference after each treatment. We concluded that, in HCPA, plasma exchange is more cost-effective than intravenous immunoglobulin.
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Margevicius, Daniel Robert. "PREVENTING STRESS SIGNALING AND INCREASED NEUROINFLAMMATION ALLEVIATES ALZHEIMER’S-LIKE PATHOLOGY IN MICE OVEREXPRESSING THE APP INTRACELLULAR DOMAIN (AICD)." Case Western Reserve University School of Graduate Studies / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=case1433275461.
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Narciso, João Henrique Fagundes Bastos. "Uso de IL-2 humana recombinante em pacientes com imunodeficiência comum variável." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5146/tde-31072008-120053/.
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Na imunodeficiência comum variável (ICV) têm sido descritas alterações de linfócitos T, incluindo a produção diminuída da interleucina-2 (IL-2). Desde que a IL-2 pode promover a produção de imunoglobulinas in vitro, nosso principal objetivo foi investigar os efeitos in vivo do tratamento com IL-2 recombinante (IL-2r) em pacientes com ICV. Foram selecionados 4 pacientes que apesar de tratamento adequado com imunoglobulina EV apresentavam infecções recorrentes. Após um período de observação de 12 meses, os pacientes receberam doses crescentes de IL-2r durante 16 semanas com reposição de imunoglobulina apenas se a IgG sérica atingisse níveis menores do que 400mg/dL. A seguir, permaneceram em observação por mais 12 meses recebendo imunoglobulina . A gravidade das infecções foi avaliada segundo um \"score\" numa escala de 3 a 10. A avaliação in vitro incluiu: quantificação dos níveis de IgG, IgA e IgM séricas; resposta linfoproliferativa à PHA; populações linfocitárias CD4+, CD8+, CD19+ e CD25+ no sangue periférico. As reações adversas à IL-2r foram leves e localizadas. Houve redução aparente do número e gravidade das infecções durante os 12 meses subseqüentes ao término da IL-2r. Os níveis da IgG sérica e das células CD4+, CD8+ e CD19+ mantiveram-se estáveis durante todo o estudo. Em 3 pacientes houve relação entre melhora clínica e aumento da proporção de linfócitos T CD25+. Isto permite supor que a remissão de infecções em alguns pacientes com ICV , sob terapêutica com IL-2r associada ou não à imunoglobulina EV, esteja parcialmente relacionada à melhora da imunidade celular. Adicionalmente, nossos dados indicam que a IL-2r pode ser utilizada de modo seguro nas dosagens e período utilizados como terapêutica adjuvante em alguns pacientes com ICV que apresentam infecções recorrentes e má resposta terapêutica à imunoglobulina endovenosaIn Common Variable Immunodeficiency (CVID) T cell function may be impaired and interleukin-2 (IL-2) production diminished. Since IL-2 stimulates immunoglobulin production in vitro, the aim of this study was to determine the in vivo effects of recombinant interleukin-2 (rIL-2) in patients with CVID. We selected four CVID patients, who despite intravenous immunoglobulin infusion (IVIG) had recurrent infections. After a twelve-month run-in period, escalating dosages of rIL-2 were administered during 16 weeks, during which rescue IVIG treatment was performed whenever serum IgG levels dropped below 400 mg/dL. During follow-up (12 months), patients were observed and treated with IVIG. Infection severity was assessed using a 3 to 10 infection score. In vitro analysis included: measurement of serum levels of IgG, IgA and IgM; lymphocyte proliferative responses to phytohaemaglutinin (PHA); CD4+, CD8+,CD19+ and CD25+ lymphocyte populations in peripheral blood. Few local side-effects were observed in 2 patients. In the follow-up period after rIL-2 treatment, patients experienced reduction of the number and severity of infections. Levels of serum IgG, CD4+, CD8+ and CD19+ were stable throughout the study. In 3 patients we observed a relation between improvement of clinical parameters and number of T CD25+ cells. These findings suggest that remission of infections in some CVID patients treated with rIL-2, in combination or not with IVIG is, in part, associated with the improvement of cell immunity. Additionally, our results indicate that rIL-2 administration is safe and may serve as adjuvant therapy in some CVID patients with recurrent infections and poor response to IVIG treatment
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Gonzalez, Henrik. "The post-polio syndrome : studies of immunology and immunomodulatory intervention /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-483-X/.
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Dastmalchi, Maryam. "Studies of immunopathogenic mechanisms and treatment of chronic, inflammatory myopathies, myositis /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-323-8/.
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Karnam, Anupama. "Role of Wnt/β-catenin pathway in the anti-inflammatory mechanism of therapeutic normal immunoglobulins Wuchereria bancrofti filaria activates human dendritic cells and polarizes T helper 1 and regulatory T cells via toll-like receptor 4 Regulatory T cells induce activation rather than suppression of human basophils." Thesis, Sorbonne université, 2019. http://www.theses.fr/2019SORUS642.
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Les immunoglobulines polyclonales intraveineuses (IVIG) sont préparées à partir de plasmas provenant de plusieurs milliers de donneurs sains et utilisées comme traitement dans de nombreuses maladies inflammatoires et autoimmunes. Lors de ma thèse, j’ai investigué si cette thérapie pouvait interférer avec la détection sérique du virus Zika chez des patients atteints du syndrome de Guillain-Barré (GBS). J’ai démontré que la thérapie par IVIG n’interférait pas avec la détection sérique du virus dans le plasma des patients atteints de GBS suivant un traitement aux IVIG. Contrairement aux souris, les IVIG peuvent activer les basophiles humains par une voie différente que celle de l’IL-33. Les IVIG induisent la sécrétion d’Il-4, IL-6 et IL-8 par interaction directe avec les IgE à la surface des basophiles. Cette fonction est dépendante de la fraction F(ab’)2 et implique l’activation de Syk. Ces résultats montrent un nouveau mécanisme dans l’activation des basophiles humains par les IVIG. La dernière partie de ma thèse m’a permis d’étudier le rôle de la voie de signalisation β-caténine sur les effets anti-inflammatoires médiées pars les IVIG. La β-caténine, composante de la voie Wnt, joue un rôle important dans la tolérogénicité des cellules dendritiques (DC) et dans la protection contre l’encéphalomyélite auto-immune expérimentale (EAE). Les données générées montrent que les IVIG activent la voie β-caténine chez les DC humains en plus de la production de Wnt 5a nécessitant une IgG complète ainsi que les co-récepteurs LRP5/6. En dépit de l’induction de β-caténine par les IVIG, cette voie est dispensable pour ses actions anti-inflammatoires in vitro et in vivo dans le modèle EAEIntravenous immunoglobulin (IVIG) is a therapeutic preparation of pooled normal IgG obtained from the several thousand healthy donors. It is established as first-line therapy for many autoimmune and inflammatory diseases. In the first part of my thesis, I have investigated if IVIG therapy interferes with the serological detection of Zika virus infection in Guillain–Barré syndrome (GBS) patients. By analyzing the plasma of GBS patients treated with IVIG for anti-Zika IgG, I have demonstrated that IVIG therapy in GBS patients does not interfere with the serological Zika detection. The second part addresses the immunoregulatory role of IVIG on human basophil function. Unlike in mice, IVIG does not require DC-SIGN-dependent IL-33 for the activation of human basophils. IVIG directly induces the activation of IL-3-primed human basophils and secretion of IL-4, IL-6, and IL-8 by directly interacting with the basophil surface-bound IgE. This function was F(ab’)2-dependent and involves Syk activation. These results demonstrate a novel mechanism of human basophil activation by IVIG. The last part unravels the signaling pathways associated with IVIG-mediated anti-inflammatory effects specifically the Wnt/β-catenin pathway, which imparts tolerogenic properties to dendritic cells (DCs) and protection against experimental autoimmune encephalomyelitis (EAE). My data shows that IVIG activates β-catenin in human DC along with upregulation of Wnt 5a. Activation of β-catenin requires intact IgG and LRP5/6 co-receptors. However, despite the activation of β-catenin by IVIG, this pathway is dispensable for its anti-inflammatory actions both in vitro and in vivo in the EAE model
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Darenberg, Jessica. "Streptococcus pyogenes infections and toxic shock syndrome : molecular epidemiology and immunotherapy /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-676-X/.
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Jablonowska, Barbara. "Recurrent spontaneous abortion : a clinical, immunological and genetic study /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med772s.pdf.
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Barna, Geny Aparecida de Oliveira. "Estudo comparativo \'in vitro\' entre preparações de imunoglobulina \'G\', para uso intravenoso, obtidas de plasma humano de variadas procedências e processadas por diferentes técnicas de separação." Universidade de São Paulo, 2001. http://www.teses.usp.br/teses/disponiveis/9/9139/tde-26032010-115630/.
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Os efeitos protetores da imunidade humoral são medidas por uma família de glicoproteínas chamadas anticorpos ou imunoglobulinas. As preparações de imunoglobulina G (IgG) utilizadas em nosso país são importantes. No Brasil, a primeira preparação de IgG foi obtida na Fundação Pró-Sangue Hemocentro de São Paulo em 1993. O presente estudo avaliou preparações de IgG obtidas de misturas de plasma humano de variadas procedências, inclusive a preparação obtida no Brasil. Foram avaliados os seguintes parâmetros: concentração protéica, distribuição das subclasses da IgG, atividade de anticorpos específicos e segurança quanto a agentes patogênicos transmissíveis pelo sangue. Em algumas preparações, a concentração protéica de IgG e a distribuição das suas subclasses estavam fora das especificações. As preparações apresentaram atividade de anticorpos específicos contra os vírus das hepatites A e B, do herpes simples, da rubéola, citomegalovírus; contra a bactéria Streptococcus pyogenes β-hemolítico do grupo A e contra o parasita Toxoplasma gondii. A qualidade de matéria-prima utilizada em algumas das preparações de IgG não foi adequada em função de reações positivas para anticorpos contra alguns agentes infecciosos, tais como HTLV I/II, HAV, HBV, HCV e Treponema pallidum. Esse estudo também mostrou a necessidade de se implantar urgente um programa abrangente para avalição das preparações de IgG a serem consumidas pela população brasileira.A family of glicoproteins, which are called antibodies or immunoglobulins (IgG), mediates the protective effects of humoral immunity. In Brazil, the IgG for intravenous use are imported from other countries. The first Brazilian immunoglobulin G for therapheutic use was obtained from human plasma at the Fundação Pró-Sangue Hemocentro de São Paulo. The present study was carried out to evaluate different preparations of IgG, human plasmad-derived, include the preparation from Brazil. The protein concentration, IgG subclass distribution, specific antibody activities and safety regarding the main blood transmitted infectious diseases were analyzed. In some preparations, IgG protein concentration and subclass distribution were different from their specifications. Some preparations showed specific antibody activity against the following antigens: A and B hepatitis virus, rubella, herpes simplex virus, citomegalovirus, measles virus, Streptococcus pyogenes β-hemolytic group A and Toxoplasma gondii. The presence of antibodies against antigens such as HTLV I/II, HAV, HBV, HCV and Treponema pallidum has compromissed the quality guaranty of the material-source (plasma) used in some preparations. This study has also showed that a complete and effective program for the quality evaluation of IgG preparations used in Brazil is needed and should be urgently established
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Li, Yi. "Intravenous immunoglobulin regulation of T cell activation through CD45." 2004. http://hdl.handle.net/1993/20084.
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Rocheleau, Danielle. "Reduction in maternal autoantibodies with intravenous immunoglobulin therapy during pregnancy." Thesis, 2019. https://hdl.handle.net/2144/38679.
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The prevalence of autoimmune lupus has increased with the onset of disease typically occurring during the women’s reproductive years. As a result, many women are experiencing obstetric complications associated with lupus, including neonatal lupus (NL) syndrome. In particular, pregnant women who have elevated anti-Ro/SSA antibodies carry an increased risk of developing NL syndrome with the most serious complication being congenital complete heard block (CHB). Currently, there is no effective treatment for CHB and affected children often require cardiac pacemakers if they survive past delivery.
Recent studies have shown an association between the concentration of anti-Ro/SSA antibodies and risk of fetal cardiac damage in NL. While the exact etiology of CHB is unknown, a therapeutic intervention aimed at reducing the concentration of these pathogenic antibodies may prevent the progression of cardiac NL in high risk pregnancies.
This proposal is a pilot, double-blind, placebo-controlled randomized study assessing the effect of IVIG therapy on the change in concentration of maternal autoantibodies throughout pregnancy. Secondary outcomes will include 2nd and 3rd degree CHB. This study could potentially add to current evidence supporting the use of IVIG therapy in anti-Ro/SSA positive mothers to prevent the development of cardiac NL. If efficacious, it would also provide clinicians a safe and cost-effective option for women at risk of delivering a child with CHB.
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Favinha, Gonçalo de Canha Passos Croca. "Immunotherapy in pediatric Guillain-Barré Syndrome: Intravenous Immunoglobulin, Plasmapheresis or both?" Master's thesis, 2020. http://hdl.handle.net/10316/97870.
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Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaO Síndrome de Guillain-Barré é uma doença auto-imune que afeta o Sistema Nervoso Periférico que afeta tanto adultos como crianças, levando a disfunção autonómica, paralisia simétrica e rapidamente progressiva, perda de reflexos e alterações respiratórias, conduzindo à necessidade de ventilação artificial. O diagnóstico desta patologia baseia-se na combinação de uma boa avaliação clínica com neuroimagem, examinação do fluído cerebral, estudos de condução nervosa e análise do soro. Sendo esta uma doença com base imune, o tratamento preferencial é a imunoterapia combinada com tratamento sintomático. Existem duas técnicas principais, em que ambas se aplicam tanto a crianças como adulto: Plasmaferese e Imunoglobulina Intravenosa. Vários estudos foram conduzidos em casos severos em crianças. Ambas as terapias provaram ser eficazes ao melhorarem a recuperação motora, diminuírem a necessidade de ventilação mecânica e acelerar a alta hospitalar. Apesar da eficácia das duas terapêuticas ser comparável, a plasmaferese não é utilizada como primeira linha devido à necessidade de material e profissionais adequados e especializados. Assim, imunoglobulina intravenosa é a primeira linha de tratamento no Síndrome de Guillain-Barré pediátrico devido à sua segurança, acessibilidade e eficácia. Contudo, os resultados não foram satisfatórios a longo prazo, o que levou à necessidade de criar estudos que combinassem ambas as terapêuticas. O Zipper Method provou que intercalando as duas terapêuticas existe uma melhoria do prognóstico quando comparando com a eficácia de cada tratamento de forma individualizada. Assim, com recurso a mais investigação, este método pode ser encarado como um tratamento de futuro no Síndrome de Guillain-Barré pediátrico.
Guillain-Barré Syndrome is an autoimmune disease of the peripheral nervous system, that affects both adults and children, causing autonomic failure, rapidly progressing and symmetric weakness, loss of reflexes and respiratory distress, leading to the need for artificial ventilation. The diagnosis of this disease arises from combining a good clinical evaluation with neuroimaging, cerebral fluid examination, nerve conduction studies and serum analysis. As an immune-mediated condition, the preferential treatment is immunotherapy combined with symptomatic care. There are two primarily used techniques, whose rationale applies to both children and adults: plasma exchange and intravenous immunoglobulin. Many studies have been conducted in severe cases, in children. Both therapies have proven to be effective in improving motor recovery, reducing the need for mechanic ventilation and hastening hospital stay. While their efficacy is comparable, plasma exchange is not used as the primary line of treatment because of its need for specialized personnel and specific equipment. So intravenous immunoglobulin is the first line treatment for pediatric Guillain-Barré Syndrome due to its accessibility, safety and efficacy. However, the results were not satisfactory in the long term, so studies combining both therapies started being developed. One of them, defining the Zipper Method, proved that intercalating both techniques may improve every outcome, when compared to each therapy on its own. So this method, pending further research, can be seen as a promising future treatment strategy in pediatric Guillain-Barré Syndrome.
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CHIH-LU, WANG, and 王志祿. "Intravenous Immunoglobulin (IVIG) Modulation of CD40L and Nitric Oxide Expression in Kawasaki Disease." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/41090286478199937351.
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博士長庚大學
臨床醫學研究所
92
Kawasaki disease (KD) is a systemic vasculitis of unknown etiology that primarily affects children under 5 years of age. The incidence of coronary artery lesions (CAL) is high in untreated KD. At present, high dose of intravenous immunoglobulin (IVIG) with aspirin become the standard treatment in KD. However, the exact immune modulating mechanism of IVIG in KD remains obscure. The failure rate of the IVIG treatment is higher than 10%. Since evidence has demonstrated that increases of nitric oxide (NO) and CD40L were involved in acute coronary syndrome. We attempted to investigate the relationship between NO，CD40L and IVIG. We analyzed NO levels and CD40L expression before and after IVIG treatment in patients with KD and correlated the severity of KD to immune mediators. We also exposed human umbilical vein endothelial cells (HUVEC) to plasma and mononuclear leukocytes (MNC) from patients with KD before and after IVIG to explore the mechanism of IVIG treatment of KD. Results showed that patients with KD had higher levels of NO that were significantly associated with the occurrence of CAL (p<0.001). The higher NO levels significantly decreased after IVIG treatment. The CD40L expression on CD4+ T cells and platelets from KD patients was also correlated with the occurrence of CAL. Further studies demonstrated that CD40L appeared to trigger vascular endothelial cells to release NO as well as chemokines (IL8, MCP-1) and adhesion molecules (sVCAM-1), which may be implicated in the vasculitis. Possible mechanism of the IVIG treatment in KD may be related to ligation of Fc portion of IVIG to monocytes, inducing large amount of PGE2 production. The PGE2 appeared to suppress CD40L expression on T lymphocytes. In contrast, high dose aspirin partly reversed but not decreased the IVIG downregulation of CD40L. Based on these results, we proposed that CD40L blocking antibodies or PGE2 may be used to treat KD patients; and the combination of IVIG with a high dose of aspirin treatment to KD should be appropriately adjusted.
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Figueiredo, Carlyn. "Interleukin-11 is a Key Mediator of Intravenous Immunoglobulin Therapy in Experimental Autoimmune Encephalomyelitis." Thesis, 2013. http://hdl.handle.net/1807/42837.
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Intravenous immunoglobulin (IVIg) has been used to treat a variety of autoimmune disorders including multiple sclerosis (MS); however, its mechanism of action remains elusive. Our results demonstrate a novel finding wherein IVIg treatment induces a dramatic surge (>1000-fold increase) in the levels of IL-11 in the circulation and that the liver is the organ of increased IL-11 transcription. Furthermore, we show that IL-11Rα knockout mice, although initially protected, become resistant to protection by IVIg during experimental autoimmune encephalomyelitis (EAE) and develop disease with a similar incidence and severity as control-treated IL-11Rα-/- mice. The inability of IVIg to prevent EAE in IL-11Rα-/- mice correlated with a failure of this agent to decrease IL-17 production by myelin-reactive T-cells in the draining lymph nodes. Finally, we show that IL-11 can directly inhibit IL-17 production by lymph node cells in culture. Together, these results implicate IL-11 as an important immune effector of IVIg in the amelioration of EAE.
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Chen, Wan-Chu, and 陳琬筑. "Diagnosis of Canine Immune-mediated Hemolytic Anemia and Evaluation of Intravenous Human Immunoglobulin Treatment." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/44252952278088048043.
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碩士國立臺灣大學
獸醫學研究所
93
Immune-mediated hemolytic anemia (IMHA) is an important immunological disease in dogs. 27 IMHA dogs treated with human intravenous immunoglobulin (hIVIG) were included in this study. The signalments, histories, clinical findings, and blood examinations results of 27 IMHA dogs were collected to understand the present situation of canine IMHA in Taiwan, and evaluated the theraprutic effects of hIVIG. In this study, middle-age females had higher risk for IMHA than males. Maltese and Shih-Tzu were the most affected breeds. The most frequently encountered clinical signs and presentions of physical examination included lethargy, anorexia, pale mucus membrane, icterus, and pigmenturia. Blood examinations presented anemia (100%) which 55.6% were regenerative and 44.4% were non-regenerative, leukocytosis (77.8%), and thrombocytopenia (71.4%) at presenting. Diagnosis of IMHA showed 77.8% with true autoagglutination, 66.7% with positive Coombs’ test, and 19% with spherocytosis. The positive result, type of antibody and titers of Coombs’ tests could not indicate good prognosis, but the therapeutic effects were corresponded with the variation of titer. Survival rate during the 6-month observation period was 63%, and no obvious side effects were observed. The IMHA dog with good prognosis showed the increasing of Hb, PCV, and RBC during 7th day to 14th day, and without or in short time with others immunosuppressive agent after hIVIG therapy. Different concentration of same product didn’t affect therapeutic effect. Another important point was also observed, that hIVIG maybe can decrese severe hemolysis after inappropriate blood transfusion. Therefore, intravenous administration of hIVIG may be a good alternative therapy for canine IMHA.
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Webster, Michelle. "Relative efficacy of intravenous immunoglobulin G in ameliorating thrombocytopenia induced by anti-platelet GPIIbIIIa versus GPIbalpha antibodies." 2006. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=450530&T=F.
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Daniella, Perri. "The Role of Intravenous Immunoglobulin Anti-A and Anti-B in Complement Activation and Red Blood Cell Phagocytosis." Thesis, 2009. http://hdl.handle.net/1807/18976.
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Intravenous immunoglobulin is a human blood derived product that is used to treat immunodeficiencies and autoimmune disorders. An adverse side effect of IVIg therapy is hemolysis. Patients who experience hemolysis are mainly blood group A or AB. Clinical laboratory studies have demonstrated that IVIg contains ABO blood group antibodies, which can bind complement proteins. This study hypothesizes that anti-A/B in IVIg will bind to A/B antigens and activate complement in a dose dependant manner, which may lead to enhanced RBC phagocytosis. This study observed that the quantity of ABO antigens does not affect the in vitro binding of IVIg to RBCs. IVIg induced C3b deposition at high doses; however, the amount of complement deposition was insufficient to enhance phagocytosis of IVIg-sensitized RBCs by monocytic THP-1 cells in vitro. These studies emphasize that hemolytic reactions involve many factors in conjunction with antibodies and complement proteins.
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Pan, Han-En, and 潘漢恩. "Cytokine Profile in Peripheral Blood Mononuclear Cells of Immune-mediated Hemolytic Anemia Affected Dogs Intravenous Administration with Human Immunoglobulin." Thesis, 2002. http://ndltd.ncl.edu.tw/handle/04157560056497689814.
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碩士國立臺灣大學
獸醫學研究所
90
Immune-mediated hemolytic anemia (IMHA) is a common cause of severe anemia in dogs. The disease is characterized by accelerating destruction or removal of red blood cells (RBC) due to presence of anti-RBC autoantibodies with or without complement involvement. Conventional treatment with high dose corticosteroids and other cytotoxic drugs may be difficult or impossible to control IMHA, and the adverse effects may be severe. Intravenous administration of human immunoglobulin (IVIG), however, is efficacious in the treatment of human or canine IMHA. The immunopathogenic mechanisms underlying IMHA are still unknown, although evidence suggests that regulatory cytokines may play an important role. The respective contribution of the Th-1 and Th-2 cytokines is still a matter of debate. Even if several mechanisms of action have been proposed, a clear description of the relevant immunomodulatory effects by IVIG in canine IMHA is still scanty. This study was designed to investigate expression of cytokine mRNA from peripheral blood mononuclear cells (PBMC) before and after therapy with IVIG in dogs with IMHA. Blood samples from IMHA dogs were collected in pre and 1, 2, 4, 8, 16, 24 weeks post IVIG therapy. PBMC was collected from blood through Ficoll-Paque® separation and total RNA was extracted by TRIzol® purification. Cytokine gene expression was measured by reverse transcription and polymerase chain reaction (RT-PCR) and standardized by the amounts of internal housekeeping gene G3PDH expression in each sample. This semiquantitative assay was performed by densitometry on the electrophoresis picture of RT-PCR products. The cytokines IFN-γ, IL-2, IL-4, and IL-10 gene expression in naive and 2 μg/mL concanavalin A (Con A)-stimulated PBMC of IMHA dogs and control dogs were compared. Eight IMHA dogs, four idiopathic and four secondary IMHA, were included and all were administrated with 1 g/kg IVIG. The results showed IVIG therapy might be a beneficial alternative treatment for idiopathic IMHA dogs. Although we can’t demonstrate the Th-2-like dominant profile in IMHA dogs as in human or rodent disease, IL-2 gene expression in idiopathic IMHA dogs was statistically decreased. In addition, the ratio of IL-10/IL-2 in those dogs was significantly higher which suggests IMHA dog might have a relative dominance of Th-2 cytokine profile. The therapeutic effect of IVIG was complicated. The cytokine profile was mild increased in naive group but was partially diminishing in ConA-stimulated group. Eventually, most of the cytokines examined in IMHA affected dogs were gradually returned to the normal level 24 weeks after IVIG therapy. These results suggest that imbalance of cytokine network may relate to the pathogenesis of IMHA. Administration of IVIG may correct this irregulation and achieve its therapeutic effect.
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Massoud, Amir Hossein. "The anti-inflammatory properties of intravenous immunoglobulin in a murine model of allergic airway disease ; effects on the development of regulatory T-cells." Thèse, 2013. http://hdl.handle.net/1866/9890.
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Les immunoglobulines intraveineuses (IVIg) constituent une préparation polyclonale d’IgG
isolée et regroupée à partir du plasma sanguin de multiples donneurs. Initialement utilisé comme
traitement de remplacement chez les patients souffrant d’immunodéficience primaire ou
secondaire, les IVIg sont maintenant largement utilisées dans le traitement de plusieurs
conditions auto-immunes, allergiques ou inflammatoires à une dose élevée, dite immunomodulatrice.
Différents mécanismes d’action ont été postulés au fil des années pour expliquer
l’effet thérapeutique des IVIg dans les maladies auto-immunes et inflammatoires. Entre autre, un
nombre grandissant de données issues de modèles expérimentaux chez l’animal et l’humain
suggère que les IVIg induisent l’expansion et augmentent l’action suppressive des cellules T
régulatrices (Tregs), par un mécanisme qui demeure encore inconnu. Également, les patients
atteints de maladies auto-immunes ou inflammatoires présentent souvent un nombre abaissé de
Tregs par rapport aux individus sains. Ainsi, une meilleure compréhension des mécanismes par
lesquels les IVIg modulent les cellules T régulatrices est requise afin de permettre un usage plus
rationnel de ce produit sanguin en tant qu’alternative thérapeutique dans le traitement des
maladies auto-immunes et inflammatoires.
Par le biais d’un modèle expérimental d’allergie respiratoire induite par un allergène, nous avons
démontré que les IVIg diminuaient significativement l’inflammation au niveau des voies
aériennes ce, en association avec une différenciation des Tregs à partir des cellules T non
régulatrices du tissu pulmonaire. Nous avons également démontré qu’au sein de notre modèle
expérimental, l’effet anti-inflammatoire des IVIg était dépendant des cellules dendritiques
CD11c+ (CDs) pulmonaires, puisque cet effet pouvait être complètement reproduit par le transfert adoptif de CDs provenant de souris préalablement traitées par les IVIg. À cet effet, il est
déjà établi que les IVIg peuvent moduler l’activation et les propriétés des CDs pour favoriser la
tolérance immunitaire et que ces cellules seraient cruciales pour l’induction périphérique des
Tregs. C’est pourquoi, nous avons cherché à mieux comprendre comment les IVIg exercent leur
effet sur ces cellules. Pour la première fois, nous avons démontré que la fraction d’IgG riche en
acide sialique (SA-IVIg) (constituant 2-5% de l’ensemble des IgG des donneurs) interagit avec
un récepteur dendritique inhibiteur de type lectine C (DCIR) et active une cascade de
signalement intracellulaire initiée par la phosphorylation du motif ITIM qui est responsable des
changements observés en faveur de la tolérance immunitaire auprès des cellules dendritiques et
des Tregs. L’activité anti-inflammatoire de la composante SA-IVIg a déjà été décrite dans des
études antérieures, mais encore une fois le mécanisme par lequel ce traitement modifie la
fonction des CDs n’a pas été établi. Nous avons finalement démontré que le récepteur DCIR
facilite l’internalisation des molécules d’IgG liées au récepteur et que cette étape est cruciale
pour permettre l’induction périphérique des Tregs.
En tant que produit sanguin, les IVIg constitue un traitement précieux qui existe en quantité
limitée. La caractérisation des mécanismes d’action des IVIg permettra une meilleure utilisation
de ce traitement dans un vaste éventail de pathologies auto-immunes et inflammatoires.Intravenous immunoglobulin (IVIg) is a therapeutic preparation of normal human polyclonal IgG derived from pooled plasma from a large number of healthy donors. Initially used as replacement therapy for patients with primary and secondary immune deficiencies, IVIg is now also widely used for the treatment of a variety of autoimmune, allergic and systemic inflammatory disorders, at high immunomodulatory doses. The beneficial effect of IVIg in autoimmune and inflammatory diseases has been attributed to different mechanisms. Increasing evidence shows that IVIg induces expansion and enhances the suppressive function of regulatory T cells (Tregs) in different experimental animal models and human subjects, through an unknown mechanism. Human inflammatory and autoimmune diseases are known to be associated with Treg deficiency. Therefore, a more precise understanding of the mechanisms by which IVIg modulate Treg populations seems to be needed for more rational use of this compound as an alternative therapy in context of various inflammatory and autoimmune disorders. Using a robust antigen-driven model of allergic airway disease, we have demonstrated that IVIg markedly attenuates airway inflammation and this effect is associated with the induction of Tregs from non-regulatory T cells in pulmonary tissues. We have also demonstrated that the antiinflammatory actions of IVIg, in our model are dependent on a population of pulmonary CD11c+ dendritic cells (DCs), as the action of IVIg could be completely replicated by adoptive transfer of CD11c+ DCs from IVIg-treated mice. we have shown that tolerogenic DCs involve in the peripheral induction of Tregs. Given the requirement of DCs in the induction of Tregs, we explored the mechanism by which IVIg interacts and modulate these cells and for the first time demonstrated that the purified sialylated fraction of human IgG (SA-IVIg) (that consists 2-5% of whole IgG) interacts with an inhibitory C-type lectin receptor on dendritic (DCIR) and this interaction triggers an ITIM intracellular signaling cascade. This subsequently results in rendering tolerogenic activities to DCs and peripheral induction of Tregs. The anti-inflammatory activity of SA-IVIg has been shown in previous studies, but the mechanism by which it modulates DCs functions is not well understood. We also demonstrated that DCIR facilitates the internalization of IgG molecules into DC and this internalization appears to be a crucial step for induction of Tregs. IVIg is a costly therapeutic compound. Characterization of the mechanism of action of IVIg can lead to a better application of this plasma based therapy in a wide range of autoimmune and inflammatory diseases.
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Yen, Meng Hsiu, and 顏盟修. "Intravenous immunoglobulin and lactoferrin: evaluation of the possible non-specific antiviral measurements for pediatric non-polio enterovirus infections, from clinical to bench studies." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/51938092964146339627.
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博士長庚大學
臨床醫學研究所
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Non-polio enterovirus infections are common infectious diseases of children worldwide including Taiwan. Although most enterovirus infections are self-limited, the severe infections including meningoencephalitis resulted from EV71 infections and hepatitis with coagulopathy in neonatal patients are potentially fatal and may accompany by sequel. The treatment of severe enterovirus infections is mainly supportive due to the lack of licensed specific anti-viral agent. This underlines the importance of developing or evaluating the potentially effective agents currently available for the treatment or prevention of enterovirus infections. In 2005 increased coxsackievirus B3 (CVB3) activity was noted in Taiwan. During this endemic of CVB3 infections we revealed the role of viral load in disease severity of infants with CVB3 infection. In addition, we noticed a rapid decline of viral load after IVIG use in the 2 patients received viral load determination before IVIG therapy. In addition in the 4 patients who suffered severe infections and received IVIG therapy within 3 days of illness, the use of IVIG was accompanied by an improvement in AST level and clinical condition. We further conducted a retrospective study to evaluate the influence of IVIG therapy on outcome with timing of IVIG therapy taken into consideration. A total of 67 neonates (52 survived and 15 died) with severe enterovirus infection were collected during a period of 16 years. Firstly the prognostic role of AST level in the first 3 days of illness was noted. A total of 41 patients received IVIG therapy, and for patients received early IVIG therapy (receiving IVIG within 3 days of illness) the timing of IVIG therapy and peak AST level were highly correlated. In addition, among all patients enrolled the patients received early IVIG therapy had a probability of survival 15 times higher than that of those patients who did not. These findings suggest that timing of IVIG therapy is likely crucial in its effectiveness and timely IVIG therapy is probably life saving for severely infected neonates. These finings also highlight the importance of timing of therapy for future studies addressing the benefit of IVIG therapy in severe neonatal enterovirus infections. Lactoferrin is a mammalian milk glycoprotein which is also present in tears, saliva, and neutrophil granules. In addition to iron binding ability, it possesses several biological functions including inhibiting several bacteria and viruses. Bovine lactoferrin now could be industrially mass produced and incorporated into several nutritional supplements including yogurt and infant formula. Its anti-rotavirus effect had been reported before. In 2002 we identified its anti-enterovirus activity towards EV71 and coxsackievirus A16. We then executed a clinical trial to evaluate the effect of oral supplement of lactoferrin in preventing enterovirus or rotavirus infection in health children aged 2 to 6 years old in 2002 and 2003. However a beneficial effect of oral supplement of lactoferrin could not be shown in this trial. There are several possible explanations for this result. Firstly, the dose of lactoferrin supplemented (70 mg/day) probably was not high enough to establish a local intestinal concentration to prevent disease. Second, enteroviruses are contagious not only by fecal-oral route but also respiratory route, through which route the viral infection could not benefit from oral supplement of LF-containing nutrients. In addition, disease burden of EV71 and rotavirus infection during the study period was low, and the school carried out a strict hygiene policy. These results and suggestions could be helpful in the design of future studies. All lactoferrin are glycosylated by 3 to 5 N-glycan chains, but the information about functions of the glycans are limited. We perform basic research focusing on the role of lactoferrin’s N-glycans in recognition and binding by ELLSA (Enzyme-linked lectinosorbent assay) with panels of applied lectins. Results show that both human and bovine lactoferrin interact strongly with several categories of lectins. The results suggest several active glycotopes of lactoferrin including oligo-mannose chain (bovine lactoferrin only), a tri-mannose core structure, an (II beta 1->2)2M structure, LFuc and sialic acid residues. These findings advance the understanding of the recognition role of glycans of lactoferrin, are probably useful in interpreting and predicting the biological functions of lactoferrin, and are probably applicable in the design of future studies. The differential anti-EV71 activities of lactoferrin peptides including the 6 polypeptides (N1 to N3, C1 to C3) tailored by structure domains was evaluated. The data showed that the anti-EV71 activity of lactoferrin is not significantly influenced by the absence of its N-glycans. Of the polypeptides tested C1 peptide (87 a.a) is sufficient to inhibit EV71 infection while lactoferricin is not. In the time of addition assay by using C1 peptide, the inhibiting EV71 activity remained when C1 peptide was added within 10 hours after viral adsorption, which suggested that the anti-EV71 activity of C1 peptide may not limited in viral adsorption stage. Enterovirus infections have been a major health problem of children in Taiwan, and vaccine or specific antiviral agents are still under evaluation or development. Before further advance is achieved, clinical or basic research of other safe, potentially effective, commercially available agents would possibly of great value in disease treatment or prevention. Hope that our findings would be an aid in clinical practice or future studies of the same scope of interest.
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Fonseca, Ana da Cunha. "A review of intravenous immunoglobulins use on treatment and management of infectious diseases: the road so far." Master's thesis, 2017. https://hdl.handle.net/10216/104910.
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Fonseca, Ana da Cunha. "A review of intravenous immunoglobulins use on treatment and management of infectious diseases: the road so far." Dissertação, 2017. https://repositorio-aberto.up.pt/handle/10216/104910.
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Rosa, Sara Daniela Botelho. "The impact of immunoglobulins on human T follicular regulatory cells." Master's thesis, 2020. http://hdl.handle.net/10451/47463.
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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020Fundamento: As células T foliculares reguladoras (Tfr) são células derivadas de células T reguladoras (Treg) de origem tímica, responsáveis pela regulação da reação de centro germinativo, fundamental para o desenvolvimento de respostas humorais contra antigénios estranhos. Estas células diferenciam-se através de várias etapas mediadas por células dendríticas e células B. Não obstante, doentes com Agamaglobulinémia ligada ao X (ALX), deficientes em células B, apresentam um maior número de células Tfr no sangue, o que sugere que as células B são necessárias apenas em estádios mais avançados de diferenciação. Dado que modelos animais deficientes em células B e saudáveis apresentam igual número de células Tfr, colocou-se a hipótese que o aumento de células Tfr em doentes ALX poderá dever-se ao efeito da administração de imunoglobulina intravenosa (IgIV) na expansão/diferenciação destas células. Métodos: De forma a investigar o impacto da administração de IgIV em células Tfr, estudou-se o efeito das Imunoglobulinas (Ig) na proliferação e ativação e nos números de células Tfr, tanto em condições in vivo, como in vitro. Para avaliar o impacto da administração de IgIV in vivo, colheram-se amostras de sangue de doentes ALX em três timepoints: antes do tratamento com IgIV (d1), 7 dias após o tratamento com IgIV (d7) e antes do tratamento subsequente (d28). Obtiveram-se os números de células Tfr e células T foliculares auxiliares (Tfh) e analisaram-se as células Tfr quanto aos marcadores de proliferação e ativação. Relativamente ao impacto in vitro das Ig, cocultivaram-se células Tfr e Tfh com diferentes concentrações de Ig e analisaram-se as células Tfr quanto à proliferação e marcadores de ativação. Resultados: No presente estudo, é demonstrado que a administração de IgIV resulta no aumento de células Tfr no sangue. Paradoxalmente, no mesmo grupo de doentes, verificou-se uma diminuição da proliferação e ativação das células Tfr no sangue após a administração de IgIV. Adicionalmente, células Tfr obtidas a partir de dadores saudáveis apresentaram o mesmo comportamento em cocultura com células Tfa e imunoglobulinas. Conclusão: No seu conjunto, estes resultados sugerem que a administração de imunoglobulina intravenosa a doentes com ALX pode resultar no aumento da diferenciação de células Tfr, explicando desta forma o maior número de células Tfr no sangue destes doentes, na ausência de aumento da proliferação das mesmas. Ademais, estas células mostraram uma baixa expressão de ICOS e PD-1, reforçando um modelo previamente proposto que defende que células Tfr em estádio precoce entram em circulação previamente à interação com células B, mantendo um fenótipo imaturo.
Background: T follicular regulatory (Tfr) cells are thymic T regulatory (tTreg) derived cells responsible for the regulation of the germinal center (GC) reaction, which is fundamental for humoral responses against foreign antigens. These cells differentiate through a complex multi-step process requiring the intervention of dendritic cells (DC) and B cells. However, X-linked agammaglobulinemia (XLA) patients, who are B cell-deficient, show higher numbers of blood Tfr cells, suggesting that B cells may only be required at later stages of differentiation. Given that B cell-depleted and B cell-sufficient animal models show equal numbers of Tfr cells, we have hypothesized that the increased number of Tfr cells in XLA patients might be due to an effect of intravenous immunoglobulins (IVIg) on Tfr cell’s expansion/differentiation. Methods: In order to investigate the impact of IVIg on Tfr cells, we studied the effect of Immunoglobulins (Ig) on Tfr cell’s numbers, proliferation and activation both in in vivo and in vitro conditions. So as to assess the in vivo impact of IVIg, blood samples were collected from XLA patients on three different timepoints: before IVIg treatment (d1), 7 days after IVIg treatment (d7) and before subsequent treatment (d28). The numbers of Tfr, T follicular helper (Tfh) and Treg cells in each timepoint were obtained and Tfr cells were analyzed for proliferation and activation markers. Regarding the in vitro impact of Ig, we co-cultured Tfr and Tfh cells sorted from healthy donors with increasingly higher concentrations of Ig and analyzed Tfr cells for proliferation and activation markers. Results: In the present study, it is shown that the administration of IVIg increases blood Tfr cell’s numbers in XLA patients. Paradoxically, we have found that blood Tfr cells show decreased proliferation and activation after IVIg administration in the same group of patients. Additionally, Tfr cells sorted from healthy donors present the same behavior in co-culture with Tfh cells and high concentrations of immunoglobulins (5 and 25 mg/ml). Conclusions: Altogether, these results hint that the administration of IVIg to XLA patients promotes Tfr cell differentiation, thus explaining the increased numbers of blood Tfr cells in these patients, in the absence of enhanced Tfr cell proliferation. Furthermore, these cells showed low expression of activation markers, reinforcing a previously proposed model stating that early stage Tfr cells enter circulation prior to B cell interaction, retaining an immature phenotype.
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Hromádková, Lenka. "Tau protein, biomarker Alzheimerovy choroby: in vitro fosforylace a charakterizace tau reaktivních protilátek." Doctoral thesis, 2018. http://www.nusl.cz/ntk/nusl-388839.
Full textAbstract:
Tau protein, a microtubule-associated protein localized in axonal projections of neurons, is a key molecule in the pathology of Alzheimer's disease (AD), the most common cause of dementia in the elderly population. Tau belongs to the group of natively unfolded proteins without globular structure and is prone to numerous posttranslational modifications (PTMs). Under pathological conditions, abnormal PTMs and misfolding of tau protein occurs and leads to oligomerization and aggregation into paired helical filaments forming neurofibrillary tangles, the histopathological hallmark of AD. Currently available drugs applied in AD treatment can only slow the disease progression and those, which halt the AD-specific neurodegenerative processes, are still missing. Very promising and evolving therapeutic approach is immunotherapy, and even immunomodulation by administration of intravenous immunoglobulin (IVIG) products, a reservoir of natural antibodies from the plasma of healthy donors, has been already tested. The discovery of naturally occurring antibodies directed to tau (nTau-Abs) in body fluids of both AD and healthy subjects and their presence in IVIG begin the investigation of their therapeutic potential. Considering a wide range of possible modifications of tau and of various tau species (oligomers,...
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Bah, Ramatoulaye. "Les immunoglobulines intraveineuses et la réponse spécifique des cellules T dans la prévention de la maladie lymphoproliférative post-greffe associée au virus Epstein-Barr chez les enfants greffés de cellules souches hématopoïétiques." Thèse, 2015. http://hdl.handle.net/1866/13540.
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