Hungarian Immunology

[An interview with writer Pál Békés]

SZEKANECZ Zoltán, SZŰCS Gabriella, SZÁNTÓ Sándor, SZABÓ Zoltán

JANUARY 20, 2007

Hungarian Immunology - 2007;6(01-02)

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Hungarian Immunology

[The immunmodulatory effect of 1,25 dihydroxyvitamin D3]

SZEGEDI Andrea, NAGY Georgina, BARÁTH Sándor, GAÁL János

[1,25 dihydroxyvitamin D3, the biologically active metabolite of vitamin D3 plays an important role not only in bone and calcium metabolism but in differentiation of many cells and in the immunomodulation. It exerts its biological effects via vitamin D receptor (VDR) expressed in antigen-presenting cells and activated T cells. VDR is a member of the superfamily of nuclear hormone receptors. The receptor- ligand interaction activates nuclear transcription factors or the receptor binds directly to vitamin D responsive elements in the promoter regions of cytokine genes. Dendritic cells (DC) are the primary targets of vitamin D3; it inhibits the differentiation and maturation of DCs, and hereby DC-dependent T cell activation. These immunomodulatory activities have been demonstrated in vitro and in different models of autoimmune diseases and transplantation in vivo. In this report we review the regulatory effects of active vitamin D3 on the immune system and the latest results emphasizing the immunomodulatory role of 1,25 dihydroxyvitamin D3 which might be utilized more in therapy.]

Hungarian Immunology

[In vitro methods for measuring phagocytosis and killing of bacteria by neutrophil granulocytes]

RADA Balázs

[Accounting for about two-thirds of our white blood cells, neutrophilic granulocytes are key members of the innate immune system of the human body. They are terminally differentiated cells equipped with numerous antimicrobial weapons. Neutrophils are the first to arrive at sites of infections; their main mission is to phagocytose and destroy bacteria and funghi entering the human body. They fullfill a central role in both the inflammatory response of the body and the coordination of the innate and acquired immune systems’ function. Their deficient performance leads to impaired resistance of the host against microbes and to higher frequency of infections; their uncontrolled function, in turn, may damage our own tissues. Because of all of this, it is highly important from both basic and clinical perspective that we know as much as possible about the function of our neutrophilic granulocytes. In this paper methods available for measuring phagocytic and killing capacities of human neutrophils are reviewed. Each method has its advantages and disadvantages. The method chosen mainly depends on experimental tools available and informations needed.]

Hungarian Immunology

[Biological therapy of arthritis and systemic autoimmune diseases - 2007]

SZEKANECZ Zoltán, TAMÁSI László

[Biological therapy acts at a specific point of inflammation. Today, rheumatoid arthritis is the prototype disease in this context due to the relatively high number of accessible patients and wellstandardized follow-up tools. However, apart from this disease, biological therapy has been introduced to the treatment of other diseases including various forms of arthritis, such as ankylosing spondylitis and psoriatic arthritis, as well as systemic autoimmune disorders, such as lupus, scleroderma, inflammatory myopathies and Sjogren’s syndrome. Anti-tumor necrosis factor-α (TNF-α) agents play a central role in biological therapy as these agents have been successfully tried in most of these diseases. However, when seeking for specific targets for biologicals, specific pathogenic factors of the given disease should be determined. For example, while anti-TNF agents seem to be most effective in various types of arthritis, anti-B cell therapy may be the first choice in other autoimmune conditions, such as lupus, Sjogren’s syndrome or dermatomyositis. It is important to consider the specific characteristics of the administered agents as there may be differences regarding side-effects.]

Hungarian Immunology

[Autoimmunity as a result of escape from RNA surveillance]

SEMSEI Imre, DARISE Farris, BACHMANN Michael

[The pathomechanisms of autoimmune diseases are still unknown. Numerous factors are thought to play a role in the formation of the diseases (genetic arrangement, hormonal factors, exogen and endogen viruses, etc.) and many hypotheses have been formulated to explain the role of these factors. Most of the theories suspect that disturbance of the immune system is the clue but according to other researchers the immune system performs properly and one has to find other alterations that could be blamed for the formation of the autoimmune diseases. The aim of our present work is to show that certain genetic alterations together with the mistake of the RNA surveillance system could lead to autoimmune reactions. Results of immune research conducted in the past two decades revealed that there are mutations in the hot spot region of exon 7 of the La gene in the peripheral lymphocytes of patients suffering from certain autoimmune diseases (Sjögren's syndrome, SLE). RNAs originated from the mutant gene contain premature termination codon and therefore the RNA surveillance mechanism should get rid of these RNAs in order to prevent the formation of mutant proteins. However, because of the mistake of the surveillance system mutant proteins are formed that could finally lead to the autoimmune reactions.]

Hungarian Immunology

[The relationship between metabolic diseases and the immune system]

SIPKA Sándor, PARAGH György, FÜLÖP Péter, MAGYAR Pál, ENDRE László, GALUSKA László

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[OBJECTIVE - Since the 60’s several publications dealt with the phenomenon how physicians inform parents of newborns about postnatal recognition of Down’s syndrome and the support they receive right after breaking the bad news. Howe - ver, the rest of these studies concentrated on surveying parental satisfaction, while relatively few international studies deal with the other side of the communicational situation, the opinion of the informer. Our study focused on the circumstances of parental information in Hungarian institutions of obstetrics in order to evaluate the possibilities for interventions. METHODS - The Down’s team operating at the University of Pécs Faculty of Health Sciences carried out a national survey in 2005 - an interview-based questionnaire filled by physicians of institutions of obstetrics - with the help of the National Register for Congenital Diseases of the National Centre for Epidemiology and Down’s Foun dation. RESULTS - The coverage of the survey reached 74%. Rest of the surveyed institutions did not have information protocol, however, 70% of them believes it would be necessary. Only 44% of the physicians received communication training and 81% of them believe they can manage communication, 33% have felt that the mother of a newborn with Down’s syndrome would expect special help that the institutions are unable to provide. CONCLUSION - There are serious problems with the circumstances of parental informing in Hungarian institutions of obstetrics. This situation would obviously require intervention. An aimed communicational training based on international experience and exploiting the openness of physicians, as well as the establishment of information protocol could be elements of such intervention.]

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[The evaluation of statin adherence in patients from the village of Méhkerék]

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[INTRODUCTION - One of the basic elements of cardiovascular prevention is lipid lowering therapy, the quality of which is indicated by the increasing rate of lipid target values achieved during recent years. Further improvement is needed and for this the enhancement of patient adherence to statin treatment is a possible way. PATIENTS AND METHODS - The prescription habits in 81 patients taking statins (41 atorvastatin and 40 rosuvastatin) from 392 randomly selected ones for another study were analysed from the database of general practitioner in the village called Méhkerék in Békés County, Hungary. RESULTS - The statin adherence of the patients was evaluated in two different ways: the estimation by the general practitioner and the determination of prescribed drug boxes during one year. There was no significant difference between the two methods. Similarly, no significant difference was found between the atorvastatin or rosuvastatin adherence. The reduction of total cholesterol was significantly greater in patients taking rosuvastatin (p=0.03). A significant correlation was found between the prescribed box numbers and the decrease of LDL- and total cholesterol. CONCLUSIONS - The patients’ adherence seems to be independent from the type of statin. For the evaluation of patient adherence the GP's simple estimation and determination of prescribed drug boxes during one year are equally appropriate. This suggests, that the GP would be able to select those patients whose education needs longer time. ]