• Title/Summary/Keyword: immune-mediated disease

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IgG4-related Disease in the Stomach which Was Confused with Gastrointestinal Stromal Tumor (GIST): Two Case Reports and Review of the Literature

  • Seo, Ho Seok;Jung, Yoon Ju;Park, Cho Hyun;Song, Kyo Young;Jung, Eun Sun
    • Journal of Gastric Cancer
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    • v.18 no.1
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    • pp.99-107
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    • 2018
  • Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibro-inflammatory disorder characterized by specific pathological findings and elevated serum IgG4 level. IgG4-RD in the stomach is rare, and occasionally diagnosed as gastric subepithelial tumor (SET) by endoscopy or computed tomography scan. Two female patients in the age group of 40-50 years were diagnosed with 4 cm sized gastric SET. One underwent laparoscopic gastric wedge resection. Another one had a history of subtotal gastrectomy for early gastric cancer and idiopathic thrombocytopenic purpura with oral steroids administration. She underwent a completion total gastrectomy with splenectomy for the gastric SET and ITP. The pathology showed storiform fibrosis, and IgG4 was positive in immunohistochemistry (IHC) stain. IgG4-RD is known as a medical disease that could be treated with oral steroids. The difficulty in preoperative diagnosis of the disease occasionally causes unnecessary gastric resection. Thus, preoperative diagnostic methods for IgG4-RD such as deep biopsy with IHC stain or magnetic resonance imaging are needed.

A Case of Cement Hardening Agent Intoxication with Acute Kidney Injury (시멘트 경화제 중독으로 인한 급성 신손상 1례)

  • Seo, Young Woo;Jang, Tae Chang;Kim, Gyun Moo;Ko, Seung Hyun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.157-160
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    • 2018
  • Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.

New therapeutic approach with extracellular vesicles from stem cells for interstitial cystitis/bladder pain syndrome

  • Dayem, Ahmed Abdal;Song, Kwonwoo;Lee, Soobin;Kim, Aram;Cho, Ssang-Goo
    • BMB Reports
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    • v.55 no.5
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    • pp.205-212
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    • 2022
  • Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic disorder characterized by suprapubic pain and urinary symptoms such as urgency, nocturia, and frequency. The prevalence of IC/BPS is increasing as diagnostic criteria become more comprehensive. Conventional pharmacotherapy against IC/BPS has shown suboptimal effects, and consequently, patients with end-stage IC/BPS are subjected to surgery. The novel treatment strategies should have two main functions, anti-inflammatory action and the regeneration of glycosaminoglycan and urothelium layers. Stem cell therapy has been shown to have dual functions. Mesenchymal stem cells (MSCs) are a promising therapeutic option for IC/BPS, but they come with several shortcomings, such as immune activation and tumorigenicity. MSC-derived extracellular vesicles (MSC-EVs) hold numerous therapeutic cargos and are thus a viable cell-free therapeutic option. In this review, we provide a brief overview of IC/BPS pathophysiology and limitations of the MSC-based therapies. Then we provide a detailed explanation and discussion of therapeutic applications of EVs in IC/BPS as well as the possible mechanisms. We believe our review will give an insight into the strengths and drawbacks of EV-mediated IC/BPS therapy and will provide a basis for further development.

Tuberous Sclerosis Complex with Crohn's Disease (크론병과 병발한 결절성경화증 1예)

  • Kim, Min Hee;Lee, Yoon Jin;Kim, Jae Young;Yi, Yoon Young;Kang, Joon Won
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.284-287
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    • 2018
  • Tuberous sclerosis complex (TSC) is an autosomal dominant disorder caused by mutation of one of two genes, TSC1 (encoding hamartin, 9q34) and TSC2 (encoding tuberin, 16p13). It invades the central nervous system and various parts of the body, causing various symptoms. Crohn's disease (CD) is a chronic immune-mediated disease that has not been clearly elucidated. It is thought to be caused by an excessive immune response of the body to bacteria that normally exist in the digestive tract with genetic factors. No cases have been reported in which both of the above-mentioned diseases occurred simultaneously. We report a case of CD in a patient with TSC. A 12-year-old boy was brought to our hospital because of abdominal pain. Skin lesions were observed in the TSC. Fundus examination revealed a hamartoma in the right retina. Brain magnetic resonance imaging revealed a subendothelial giant cell astrocytoma (SEGA). On the basis of these findings, he was diagnosed as having TSC. Blood test results showed increased levels of inflammatory markers. On abdominal ultrasonography, his colon walls were observed to be thickened with increased vascularity of the proximal ascending colon, ileocecal valve, and terminal ileum. Colonoscopy revealed discontinuous ulcerations and inflammations of the ileum, IC valve, and cecum, similar to those found in CD. Everolimus was administered orally for the SEGA but was discontinued frequently owing to the exacerbation of CD. The possibility of CD should be kept in mind in patients with TSC considering to undergo treatment for SEGA.

Effect of Bacillus Subtilis-based Direct-fed Microbials on Immune Status in Broiler Chickens Raised on Fresh or Used Litter

  • Lee, K.W.;Lillehoj, H.S.;Jang, S.I.;Lee, S.H.;Bautista, D.A.;Siragusa, G.R.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.11
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    • pp.1592-1597
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    • 2013
  • Type of dietary direct-fed microbials (DFMs) or poultry litter could directly influence the composition of gut microbiota. Gut microbiota plays an important role in shaping the developing immune system and maintaining the homeostasis of the mature immune system in mammal and chickens. The present study was carried out to investigate the interaction among litter, DFMs and immunity in broiler chickens exposed to a field-simulated environment. Immune status of broiler chickens was assessed by serum antibodies against Eimeria spp. and Clostridium spp. and intestinal cytokine mRNA expression. The current experimental design had a $3{\times}2$ factorial arrangement of treatments with three types of litter, i.e., fresh litter or used litter that was obtained from a farm with no disease outbreak (used litter) or a farm with history of a gangrenous dermatitis outbreak (GD litter), and two dietary treatments with or without DFMs. It was found that either DFM addition or type of litter significantly affected anticoccidial antibody levels of broiler chickens at d 42. In general, dietary DFMs increased the anticoccidial antibodies in the fresh-litter raised chickens, but lowered the levels in the GD-litter raised chickens. Serum antibodies against Clostridium perfringens ${\alpha}$-toxin were significantly (p<0.05) higher in chickens raised on GD litter compared with those raised on fresh litter. Cytokine mRNA expression was significantly (p<0.05) altered by either the type of litter or DFMs. Of interest, dietary DFMs lowered interferon-${\gamma}$, interleukin 1beta, and CXCLi2 cytokine mRNA expression in chickens raised on fresh litter but increased them in GD-litter raised chickens. In conclusion, dietary DFMs modulate various immune parameters of broiler chickens, but the DFM-mediated effects were dependent upon the type of litter on which chickens were raised.

Effects of Gunleetang Gagambang Extract on Antitumoral Immunological Response and the Side Effect Induced by Antitumoral Agents (군리탕가감방(君理湯加減方)이 항종양(抗腫瘍) 면역반응(免疫反應)과 항암제로 유발(誘發)한 부작용(副作用)에 미치는 영향(影響))

  • Yui, Guyng-Tea;Moon, Suk-Jae;Moon, Goo;Won, Jin-Hee
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.4 no.1
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    • pp.71-87
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    • 1998
  • Even though appropriate immune response is necessary for the survival of the individual, excessive or insufficient immune Response might cause autoimmune or allergic disease. So the immune response must be controlled to the degree that is beneficial for the well being of the individual. This study was undertaken to know the effects of Gunleetang Gagambang on the immune system of the mouse. Gunleetang Gagambang has been used for cure of tumor as a traditional medicine without any experimental evidence to support the rational basis for its clinical use. This study was carried out to evaluate the possible therapeutic or antitumoral effects of Gunleetang Gagambang extract against tumor, and to carry out some mechanisms responsible for its effect. Some kinds of tumor were induced by the typical application of 3-methylcholanthrene(MCA) or by the implantation(s.c) of malignant tumor cells such as leukemia cells(3LL cells) or sarcoma cells(S180 cells). Treatment of the Gunleetang Gagambang on water-extract(dailly 1mg/mouse, i. p.) was continued for 7 days prior to tumor induction and after that the treatment was lasted for 20 days. Against squamous cell carcinoma induced by MCA, Gunleetang Gagambang decreased not only the frequency of tumor production but also the number and the weight of tumors per tumor bearing mice(TBM). Gunleetang Gagambang on also significantly suppressed the development of 3LL cell and S180 cell-implanted tumors in occurrence-frequency and their size. and some developed tumors were regressed by the continuous treatment of Gunleetang Gagambang extract into TBM. In vitro, treatment of Gunleetang Gagambang extract had no effect on the growth of some kinds of cell line such as FsaII, A431 strain but significantly inhibited the proliferation of 3LL, S180 cells and augmented the DNA synthesis of mitogen-activated lymphocytes. Gunleetang Gagambang also stimulated the migrative ability of leukocyte, the MIF and IL-2 production of T lymphocytes, but not IL 6 production of B cells. Gunleetang Gagambang administration to mice enhanced NK cells activities. These results demonstrated that Gunleetang Gagambang extract exhibited a significant prophylactic benefits against tumors and its antitumor activity was manifested depending on the type of tumor cells. And these results also suggested that effect of Gunleetang Gagambang might be chiefly due to nonspecitie enhancement of NK cell activities and cell-mediated immune responses.

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Profiling of remote skeletal muscle gene changes resulting from stimulation of atopic dermatitis disease in NC/Nga mouse model

  • Lee, Donghee;Seo, Yelim;Kim, Young-Won;Kim, Seongtae;Choi, Jeongyoon;Moon, Sung-Hee;Bae, Hyemi;Kim, Hui-sok;Kim, Hangyeol;Kim, Jae-Hyun;Kim, Tae-Young;Kim, Eunho;Yim, Suemin;Lim, Inja;Bang, Hyoweon;Kim, Jung-Ha;Ko, Jae-Hong
    • The Korean Journal of Physiology and Pharmacology
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    • v.23 no.5
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    • pp.367-379
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    • 2019
  • Although atopic dermatitis (AD) is known to be a representative skin disorder, it also affects the systemic immune response. In a recent study, myoblasts were shown to be involved in the immune regulation, but the roles of muscle cells in AD are poorly understood. We aimed to identify the relationship between mitochondria and atopy by genome-wide analysis of skeletal muscles in mice. We induced AD-like symptoms using house dust mite (HDM) extract in NC/Nga mice. The transcriptional profiles of the untreated group and HDM-induced AD-like group were analyzed and compared using microarray, differentially expressed gene and functional pathway analyses, and protein interaction network construction. Our microarray analysis demonstrated that immune response-, calcium handling-, and mitochondrial metabolism-related genes were differentially expressed. In the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology pathway analyses, immune response pathways involved in cytokine interaction, nuclear factor-kappa B, and T-cell receptor signaling, calcium handling pathways, and mitochondria metabolism pathways involved in the citrate cycle were significantly upregulated. In protein interaction network analysis, chemokine family-, muscle contraction process-, and immune response-related genes were identified as hub genes with many interactions. In addition, mitochondrial pathways involved in calcium signaling, cardiac muscle contraction, tricarboxylic acid cycle, oxidation-reduction process, and calcium-mediated signaling were significantly stimulated in KEGG and Gene Ontology analyses. Our results provide a comprehensive understanding of the genome-wide transcriptional changes of HDM-induced AD-like symptoms and the indicated genes that could be used as AD clinical biomarkers.

Alteration of Biochemical Profiles after High-Dose Intravenous Immunoglobulin Administration in Kawasaki Disease (가와사끼병에서 고용량 정맥용 면역글로불린 투여 후 생화학 지표들의 변화)

  • Lee, Ji-Won;Lee, Kyung-Yil
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.817-820
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    • 2003
  • Purpose : Intravenous immunoglobulin(IVIG) has been used as an immunomodulatory treatment for several immune-mediated diseases. The early effect of high-dose IVIG on biochemical profiles including lipids and proteins was evaluated in patients with Kawasaki disease(KD). Methods : Twelve children with KD(nine boys) were treated with IVIG of 2 g/kg over 12 hours. Serial sera were collected from the patients four times : before IVIG treatment and two hours, 24 hours and seven days after IVIG treatment. The samples were frozen at $-20^{\circ}C$ before biochemical analysis. Results : A significant decrease in albumin concentration was found two hours h and 24 hours after IVIG treatment, but this recovered to the pretreatment level after seven days. Total cholesterol and triglyceride increased slightly after seven day. A significant decrease in HDL-cholesterol and C-reactive protein was seen two hours and 24 hours after IVIG treatment. Conclusion : High-dose IVIG affects immediate changes in protein profiles and HDL-cholesterol in KD. Changes in HDL-cholesterol induced by IVIG may be the result of changes in systemic protein metabolism.

Two cases of central nervous system complications caused by Mycoplasma pneumoniae infection (Mycoplasma pnuemonia 감염에 의한 중추신경계 합병증 2례)

  • Kim, Shin Mi;Heo, Ji Seung;Shim, Eun Jung;Lee, Dae Hyoung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.533-537
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    • 2008
  • Mycoplasma pneumoniae (M. pneumoniae) infection causes a wide variety of clinical manifestations in children and young adults, the main one being pneumonia. M. pneumoniae is transmitted from person to person by infected respiratory droplets. Symptoms caused by M. pneumoniae infection can be divided into those involving the respiratory tract, and those caused by extrapulmonary disease. M. pneumoniae infections may cause central nervous system (CNS) complications-with encephalitis being the most frequent-and stroke being a rare complication. The pathogenesis of the CNS disease is unclear; possibilities include direct infection and an immune-mediated reaction. We present two cases of CNS complications subsequent to infection with M. pneumoniae; both cases had convincing evidence of preceding M. pneumoniae respiratory disease with no evidence of viable M. pneumoniae in the cerebrospinal fluid. We report cases of encephalitis and stroke following a recent M. pneumoniae infection.

Recent Progress in Development of Vaccines against Avian Coccidiosis (조류 콕시듐증의 백신개발에 대한 최근의 진보)

  • Lillehoj, Hyun S.
    • Korean Journal of Poultry Science
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    • v.26 no.3
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    • pp.149-170
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    • 1999
  • Protozoa of the genus Eimeria are the etiologic agents of avian coccidiosis, the most economically important Parasitic disease for the poultry industry. Coccidia multiply in intestinal epithelial cells of a wide range of hosts, including livestock in addition to poultry. Chemotherapy is extensively used to control coccidiosis. However, development of drug resistance by Eimeria parasites, the intensive cost and labor involved in the identification of new anticoccidial compounds and public awareness of drug residues in foods warrant alternative methods to prevent coccidiocic in the fast growing poultry industry. For these reasons, there is a great interest in developing vaccines against avian coccidiosis. Live Eimeria vaccines confer protective immunity, however a significant disadvantage of using these types of vaccines is their pathogenicity. Live parasites with attenuated pathogenicity also usually produce immunity but may revert back to a pathogenic form and may be contaminated with other pathogenic organisms. Killed Eimeria vaccines are safer but, unlike live attenuated vaccines, are not able to generate cytotoxic T lymphocyte responses. Recombinant vaccines are biochemically purified proteins produced by genetic engineering that consist of particular epitopes or metabolites of Eimeria. Unlike live attenuated organisms, recombinant vaccines do not possess as much risk and generally are able to induce both humoral and cell mediated immunity. DNA vaccines consist of genes encoding immunogenic proteins of pathogens that are directly administered into the host in a manner that the gene is expressed and the resulting protein generates a protective immune response. Although all of these different types of vaccines have been applied to coccidiosis, this disease continues to cause substantial morbidity and mortality in the poultry industry. Future development of an effective vaccine against coccidiosis will depend on further investigation of protective immunity to Eimeria infection and identification of important immundgenic parasite molecules.

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