Hungarian Immunology

[Biologic therapies in the vasculitides]

SZÁNTÓ Antónia

AUGUST 20, 2003

Hungarian Immunology - 2003;2(04)

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Hungarian Immunology

[Our archaic heritage: the innate immunity. The cellular immunity of Drosophila]

ANDÓ István, LAURINYECZ Barbara, NAGY István, MÁRKUS Róbert, FLORENTINA Rus, VÁCZI Balázs, ZSÁMBOKI János, FEHÉR László, ELISABETH Gateff, DAN Hultmark, KURUCZ Éva

[Authors describe the essentials of the cellular immunity of Drosophila. They describe the Drosophila CD system, the main blood cell lineages and a blood cell differentiation model based on the expression of the CD antigens.]

Hungarian Immunology

[The role of the complement system in the primary recognition processes and in the regulation of adaptive responses]

ERDEI Anna

[It is known for long that the complement system present in blood and other body fluids is able to kill pathogenic microbes as a result of activation. It is also well-known that certain complement components enhance phagocytosis by opsonizing foreign substances. In addition to these roles, recent experimental results point to novel functions of certain complement proteins/receptors, namely to their contribution to the development and regulation of the adaptive response and their capacity to influence the interaction between the innate and the adaptive immune systems. During these processes certain proteins of the complement system recognise non-self structures and distinguish them from the body’s own constituents/cells. This step initiates the activation of the cascade generating several biologically active molecules, which then regulate various immune reactions.]

Hungarian Immunology

[Models of immune recognition: presence and future]

GERGELY János

[The prevailing theories of immune recognition for over 50 years were based on the idea that the immune system functions by discriminating self and nonself. Since the self-nonself theories failed to explain a number of immune phenomena new models were suggested, such as the ”infectious nonself” and the ”danger” models. The review outlines and compares these models of immune recognition.]

Hungarian Immunology

[Pathogen-associated molecular pattern of bacteria and its recognition by the host]

KOCSIS Béla, EMÕDY Levente

[Pathogen-associated molecular pattern of bacteria is determined by a molecular complementarity between the host and the microorganism. The process of pathogenesis is initiated through recognition of bacterial components or products by receptor molecules of the host organism. Constant structural components like the lipopolysaccharide in Gramnegative and lipotheichoic acid in Gram-positive bacteria are recognised by receptor molecules present in a wide range of host species, and in this way they elicit interactions and pathologic processes generally present in bacterial infections. At the same time accessorial components (adhesins, capsular material) or extracellular products (exotoxins, enzymes) mediate specific interactions which determine host species or organ specificity according to the molecular structure of the virulence factor and the specific host/organ receptor. The pathogen-associated molecular pattern is subject to changes as genom plasticity in bacteria allows evolution of virulence through recombinations and pathoadaptive mutations. Actual expression of accessorial virulence factors is frequently governed by complicated regulatory mechanisms as an adaptative response to environmental stimuli present in the host.]

Hungarian Immunology

[The role of Toll-like receptors in the early steps of innate inmunity. Signaling pathways, responses on the level of cells and the organism]

PRECHL József

[The family of Toll-like receptors are currently one of the most intensively studied group of proteins in immunology. Their ligands include a wide range of microbe-derived molecules, they are expressed on a number leukocyte populations and regulate immune responses very efficiently. In this review we characterize known common and individual signaling pathways of the receptor family and their interference with effects of other receptors, and describe the outcome of TLR signaling on the level of the cells and the organism.]

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Introduction - Our aim is to present a rare case where a child had delirium manifestation after instillation of cyclopentolate. Case presentation - A 7-year old patient was seen in our outpatient clinic, and cyclopentolate was dropped three times at 10 minutes intervals in both eyes. The patient suddenly developed behavioral disorders along with gait disturbance, and complained of visual hallucinations 20-25 minutes after the last drop. The patient was transferred to intensive care unit and 0.02 mg/kg IV. physostigmine was administered. The patient improved after minutes of onset of physostigmine, and was discharged with total recovery after 30 minutes. Conclusion - Delirium is a rare systemic side effect of cyclopentolate. The specific antidote is physostigmine, which can be used in severely agitated patients who are not responding to other therapies.

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[The treatment of Parkinson’s disease depends on the symptoms of the patients and obviously the stage of the disease. Several different approaches can be found in the literature. Based on the published data, in this review we try to summarize the different approaches to the disease stages and theirs’ clinical relevance. Actually, one of the most important issue is the recognition of advanced stage and therefore we reviewed the device-aided therapies. ]

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[Notes on the management of hypertension in chronic kidney disease ]

AMBRUS Csaba

[The prevalence of hypertension among pa­tients with chronic kidney disease is high, reaching more than 80%. Hypertension is both one of the main causes and also the most common consequence of chronic kidney disease. It is also a main factor responsible for the high cardiovascular morbidity and mortality in this patient population. Blood pressure control can improve patient outcomes, lower cardiovascular risk and slow down the progression of kidney dis­ease, irrespective of the underlying cause. The optimal therapy should therefore focus not only on blood pressure reduction but also on renoprotection. Basic understanding of the renal pathophysiology in hypertension and renal effects of various medications is of paramount importance. In this review, we summarized cornerstones of the antihypertensive therapy in patients with chronic kidney disease. The management of patients receiving kidney replacement therapies, such as hemodialysis, peritoneal dialysis or transplanta­tion requires special knowledge and expe­rience, therefore it is not discussed here. The aim of this review was to allow non-nephrologist physicians to take care of their kidney patients with more confidence and effectiveness.]

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[The objective assessment of the changes in the tumor burden along with cancer therapy has essential importance. Recently, the quantitative evaluation of the radiological tumor response was undergone several changes. For conventional chemotherapy of solid tumors the standard procedure has been RECIST since 2000. The targeted therapies trigger other pathophysiological changes in the cells than the cytotoxic agents, accordingly the morphological changes show a new picture. Therefore the targeted therapies require a new evaluation system, that takes into consideration not only the tumor size, but other changes as well, the changes of attenuation that corresponds with the proportion of the viable cells. In case of the targeted therapies in substantial clinical was experienced even without signifi cant morphological changes in the tumour size. As a consequence, the traditional, size-based criteria system can underestimate the effi ciency of the new types of treatments. To eliminate this problem new evaluation systems were created taking the tumortypes and treatment protocolls into consideration. The estimation of the early tumor response to targeted therapy also has high importance. In assessment of the response functional imaging methods are used more frequently. The role of PET has already been defi ned in numerous tumortypes, however the determination of the position of some promising functional examinations still require further studies.]

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[The treatment of advanced Parkinson’s disease is challenging for both physicians and caregivers. The device-aided therapies need expertise and dedicated hospital centers. In this summary we have concluded the available data and recommendation for the treatment options in advanced Parkinson’s disease and adopt them to the daily care in Hungary. ]