• Title/Summary/Keyword: Immunosuppressive therapy

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Combined Cytosine Arabinoside and Prednisolone Therapy for Meningoencephalitis of Unknown Etiology in 2 Dogs (원인불명의 수막뇌염을 보인 개에서 Cytosine Arabinoside와 Prednisolone으로 치료한 2례)

  • Kim, Tae-Ho;Seo, Kyoung-Won;Lee, Young-Heun;Hwang, Cheol-Yong;Lee, Young-Won;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.462-467
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    • 2010
  • A Maltese (5-years old, castrated male) and a Yorkshire Terrier (8-years old, intact female) were referred to Seoul National University Hospital for Animals with ataxia, circling, depression and anorexia. It was suspected to meningoencephalitis of unknown etiology (MUE) based on neurological signs, magnetic resonance imaging findings, cerebrospinal fluid analysis and canine distemper virus antigen test. Immunosuppressive dose of corticosteroid was initially chosen to treat in two dogs. However, the clinical signs were relapsed and side effects had arisen including polyuria, polydipsia, calcinosis cutis, liver enzyme elevation, weight gain and abdominal distension. Combination therapy of cytosine arabinoside (CA) and prednisolone (PDS) was tried. With this combination, the clinical signs were resolved and the side effects were alleviated. The dose of PDS was tapered to 0.5 mg/kg q48h in one case and the PDS was discontinued in the other case. These cases suggested that combined CA and PDS therapy may be significantly useful for the treatment of MUE uncontrolled by PDS alone.

Differentiation of Human Mesenchymal Stem Cells towards Neuronal Lineage: Clinical Trials in Nervous System Disorders

  • Hernandez, Rosa;Jimenez-Luna, Cristina;Perales-Adan, Jesus;Perazzoli, Gloria;Melguizo, Consolacion;Prados, Jose
    • Biomolecules & Therapeutics
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    • v.28 no.1
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    • pp.34-44
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    • 2020
  • Mesenchymal stem cells (MSCs) have been proposed as an alternative therapy to be applied into several pathologies of the nervous system. These cells can be obtained from adipose tissue, umbilical cord blood and bone marrow, among other tissues, and have remarkable therapeutic properties. MSCs can be isolated with high yield, which adds to their ability to differentiate into non-mesodermal cell types including neuronal lineage both in vivo and in vitro. They are able to restore damaged neural tissue, thus being suitable for the treatment of neural injuries, and possess immunosuppressive activity, which may be useful for the treatment of neurological disorders of inflammatory etiology. Although the long-term safety of MSC-based therapies remains unclear, a large amount of both pre-clinical and clinical trials have shown functional improvements in animal models of nervous system diseases following transplantation of MSCs. In fact, there are several ongoing clinical trials evaluating the possible benefits this cell-based therapy could provide to patients with neurological damage, as well as their clinical limitations. In this review we focus on the potential of MSCs as a therapeutic tool to treat neurological disorders, summarizing the state of the art of this topic and the most recent clinical studies.

A Case of Azathioprine Induced Severe Myelosuppression and Alopecia Totalis in IgA Nephropathy

  • Kim, Jae Choon;Kim, Ye Kyung;Hyun, Hye Sun;Park, Eu Jin;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.35-39
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    • 2017
  • Azathioprine is commonly used as immunosuppressive therapy for various inflammatory diseases including chronic glomerulonephritis. Myelosuppression is a common side effect of azathioprine, resulting in the need for dose reduction. However, severe pancytopenia or alopecia is not often encountered. Here, we report a case of severe myelosuppression, and alopecia totalis that occurred after azathioprine treatment in a patient with IgA nephropathy. A 10-year-old boy with IgA nephropathy was treated with oral deflazacort and later with azathioprine. After 4 weeks, the patient complained of hair loss, and despite a dose reduction in azathioprine, he developed bone marrow suppression and alopecia totalis in two weeks. The blood indices and alopecia of the patient had returned to normal after azathioprine withdrawal and 3 consecutive doses of granulocyte colony-stimulating factor. We suggest that physicians remain vigilant to the side effects of azathioprine. Unusual hair loss after azathioprine treatment might suggest a defect in the metabolism of the drug, warranting the discontinuation of azathioprine to prevent more severe side effects.

A Pharmacological Advantage of Ursodeoxycholic Acid in Cytoprotection in Primary Rat Microglia

  • Joo, Seong-Soo;Hwang, Kwang-Woo;Lee, Do-Ik
    • Molecular & Cellular Toxicology
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    • v.1 no.1
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    • pp.40-45
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    • 2005
  • Ursodeoxycholic acid (UDCA) has long been used as an adjuvant or first choice of therapy for liver disease. Commonly, UDCA has been reported to play a role in improving hyperbilirubinemia and disorder of bromsulphalein. More commonly, UDCA has been used in reducing the rate of cholesterol level in bile juice that can cause cholesterol stone. The effects on the promotion of bile acid release that leads an excretion of toxic materials and wastes produced in liver cells as well as various arrays of liver disease such as hepatitis. Other than already reported in clinical use, immunosuppressive effect has been studied, especially in transplantation. In the study, we hypothesized that UDCA might have a certain role in anti-inflammation through a preventive effect of pro-inflammatory potentials in the brain macrophages, microglia. We found that the treatment of $200\;{\mu}g/ml$ UDCA effectively suppressed the pro-inflammatory mediators (i.e. nitric oxide and interleukin-$1{\beta}$) in rat microglia compared to comparators. Interestingly, RT-PCR analysis suggested that UDCA strongly attenuated the expression of $IL-1{\beta}$ that was comparable with cyclosporine A at 48 h incubation. Conclusively, we found that UDCA may playa cytoprotective role in microglial cells through direct or indirect pathways by scavenging a toxic compound or an anti-inflammatory effect, which are known as major causes of neurodegenerative diseases.

Cyclophilin A as a New Therapeutic Target for Hepatitis C Virus-induced Hepatocellular Carcinoma

  • Lee, Jinhwa
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.5
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    • pp.375-383
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    • 2013
  • Hepatocellular carcinoma (HCC) related to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections is thought to account for more than 80% of primary liver cancers. Both HBV and HCV can establish chronic liver inflammatory infections, altering hepatocyte and liver physiology with potential liver disease progression and HCC development. Cyclophilin A (CypA) has been identified as an essential host factor for the HCV replication by physically interacting with the HCV non structural protein NS5A that in turn interacts with RNA-dependent RNA polymerase NS5B. CypA, a cytosolic binding protein of the immunosuppressive drug cyclosporine A, is overexpressed in many cancer types and often associated with malignant transformation. Therefore, CypA can be a good target for molecular cancer therapy. Because of antiviral activity, the CypA inhibitors have been tested for the treatment of chronic hepatitis C. Nonimmunosuppressive Cyp inhibitors such as NIM811, SCY-635, and Alisporivir have attracted more interests for appropriating CypA for antiviral chemotherapeutic target on HCV infection. This review describes CypA inhibitors as a potential HCC treatment tool that is contrived by their obstructing chronic HCV infection and summarizes roles of CypA in cancer development.

Skin Graft-versus-host Disease Following Autologous Stem Cell Transplantation for Multiple Myeloma

  • Lee, Sung-Eun;Yoon, Jae-Ho;Shin, Seung-Hwan;Park, Gyeongsin;Min, Chang-Ki
    • IMMUNE NETWORK
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    • v.13 no.3
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    • pp.107-110
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    • 2013
  • Graft-versus-host disease (GVHD) is a common complication of allogeneic stem cell transplantation (allo-SCT). However, a similar syndrome has been reported in autologous stem cell transplantation (ASCT) as well. The target organs of GVHD in ASCT are the skin, liver and gastrointestinal (GI) tract, which are consistent with those in allo-SCT. Histologic findings from the skin and the mucosa of the GI tract also show similar features. Here we describe a case of autologous GVHD involving the skin of a patient who underwent ASCT for multiple myeloma. In this patient, the response to a total prednisone dose of 0.5 mg/kg/day was unsatisfactory, and the patient required more intensive and prolonged immunosuppressive therapy with slow tapering.

A Case of Autoimmune Chronic Pancreatitis in a Child (자가면역성 만성 췌장염으로 진단된 소아 1예)

  • Choi, In-Young;Jin, So-Hee;Choi, Kyung-Dan;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.215-220
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    • 2007
  • We present a case of autoimmune chronic pancreatitis in a previously healthy child without any history of autoimmune disease. A 12-year-old boy was admitted to the hospital with abdominal pain. The serum amylase, lipase, and IgG levels were elevated and autoantibodies (antinuclear antibody, antineutrophil antibody) were detected. An abdominal CT (computed tomographic) scan revealed diffuse enlargement of the pancreas. ERCP (endoscopic retrograde cholangiopancreaticography) demonstrated an irregular stricture of the main pancreatic duct in the pancreas tail. After two years of oral steroid and immunosuppressive drug therapy, the clinical, laboratory and radiological findings were improved. The patient has been symptom-free for 18 months after the discontinuation of medication.

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A Case of Diffuse Alveolar Hemorrhage Associated with Cytomegalovirus Pneumonia (거대세포바이러스 폐렴에 동반된 미만성 폐포출혈 1예)

  • Cho, Yong Duck;Choi, Hye Sook;Park, Myung Jae
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.309-313
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    • 2008
  • Cytomegalovirus (CMV) pneumonia is a serious opportunistic infection in an immunocompromised host such as an AIDS patient or transplant recipient undergoing immunosuppressive therapy. Diffuse alveolar hemorrhage (DAH) is a relatively uncommon condition and it occurs most often in patients with systemic autoimmune disease. However, various types of infectious pneumonia with Mycoplsma hominis, Stenotrophomonas maltophilia and Pneumocystis jirovecii have been reported to be associated with the development of DAH. The association of CMV infection with the development of DAH has rarely been reported. We experienced a case of DAH associated CMV pneumonia and the patient was successfully treated with the use of antiviral agents and steroids.

Adaptogenic effects of Panax ginseng on modulation of cardiovascular functions

  • Irfan, Muhammad;Kwak, Yi-Seong;Han, Chang-Kyun;Hyun, Sun Hee;Rhee, Man Hee
    • Journal of Ginseng Research
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    • v.44 no.4
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    • pp.538-543
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    • 2020
  • Cardiovascular diseases are a rapidly growing epidemic with high morbidity and mortality. There is an urgent need to develop nutraceutical-based therapy with minimum side effects to reduce cardiovascular risk. Panax ginseng occupies a prominent status in herbal medicine for its various therapeutic effects against inflammation, allergy, diabetes, cardiovascular diseases, and even cancer, with positive, beneficial, and restorative effects. The active components found in most P. ginseng varieties are known to include ginsenosides, polysaccharides, peptides, alkaloids, polyacetylene, and phenolic compounds, which are considered to be the main pharmacologically active constituents in ginseng. P. ginseng is an adaptogen. That is, it supports living organisms to maintain optimal homeostasis by exerting effects that counteract physiological changes caused by physical, chemical, or biological stressors. P. ginseng possesses immunomodulatory (including both immunostimulatory and immunosuppressive), neuromodulatory, and cardioprotective effects; suppresses anxiety; and balances vascular tone. P. ginseng has an antihypertensive effect that has been explained by its vasorelaxant action, and paradoxically, it is also known to increase blood pressure by vasoconstriction and help maintain cardiovascular health. Here, we discuss the potential adaptogenic effects of P. ginseng on the cardiovascular system and outline a future research perspective in this area.

Studies on the Experimental Heart and Heart-Lung Transplantation in the Mongrel Dogs for the Purpose of Clinical Application (임상적용을 위한 한국산 잡견에서의 실험적 심장및 심폐 이식술)

  • 이정렬
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.458-468
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    • 1992
  • With the aid of extracorporeal circulation, nine dogs underwent orthotopic cardiopulmonary transplantation after preservation of the donor heart in a hypothermic amino acid[glutamate, aspartate] enriched high potassium extracellular solution, and preservation of the donor lung with hypothermic low potassium dextran solution from June 1990 to May 1991. The mean body weights of dogs were 20kg and the recipients` preoperative hematologic and hemodynamic pictures were within normal range except slightly decreased level of albumin and total protein, which was supposed to be due to malnutrition. The following modifications of the original Stanford technique were emphasized: [1] the posterior mediastinum is dissected as little as possible with meticulous hemostasis; [2] the surgical procedure is kept away from the phrenic and vagus nerves; [3] the tracheal anastomosis may be wrapped with recipient`s pulmonary artery flap or surrouding soft tissues. A combination of Cyclosporine, Azathioprine, corticosteroid was used as perioperative immunosuppressive therapy. Postoperatively all recipients could be weaned from extracorporeal circulation, showing favorable vital signs, but within 24 hours, irreversible congetive heart failure, ascites, arrhythmias developed with a mean survival time 13.6$\pm$6.6[n=9, range=6~26] hours. Hemoglobin and platelet counts were significantly[p<0.05] decreased postoperatively, which is thought to be attributed to blood damage by cardiopulmonary bypass and hemodilution. Postmortem finding included multiple subendocardial patch hemorrhage in both atrial and ventricular cavities, pulmonary and liver congestion, and all tracheal anastomoses were intact. Further consideration about quality control of the animal, infection, rejection, the effect of cardiopulmonary bypass on the experimental animal is required to improve the results.

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