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

[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

[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.]

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

[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.]

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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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[Primary membranous nephropathy is a common glomerular disorder characterized by subepithelial immune deposits. The pathomechanism underlying these lesions has only recently been elucidated: M-type phospholipase A2receptor (PLA2R) protein emerged as being the leading autoantigen. Antibodies to PLA2R, typically of IgG4 subclass are expressed in 70-80% of patients with primary membranous nephropathy. The level of autoantibody to PLA2R was shown to correlate with disease severity and to change parallel with disease activity in response to therapy. While mild forms of the disease are prone to spontaneous remission and carry excellent prognosis, severe forms often progress into end-stage renal disease without treatment and necessitate immunosuppression. The latest guidelines recommend the application of corticosteroids with alkylating agents or calcineurin inhibitors as first-line therapy. Promising new therapies that are currently being explored for this disease include rituximab, mycophenolate mofetil, and adrenocorticotropic hormone.]

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[Dizziness is one of the most common causes of medical visits. Management of the dizzy patient may be challenging both for the general practitioner, in emergency departments, and special clinics, as behind a seemingly homogeneous clinical presentation several very different etiologies may occur. Research of the last two century enriched our knowledge about physiology and pathophysiology of the vestibular system. Much knowledge is now available about the labyrinth being able to sense head motions and gravity, processing of afferent vestibular stimuli, reflectory oculomotor and postural control, or recovery of the vestibular system. Based on scientific results new beside tests have been introduced including provocation maneuvers for detecting ectopic otoliths in different semicircular canals, head impulse test to examine function of the vestibulo-ocular reflex, and the HINTS+ battery for differentiation of peripheral or central origin of an acute vestibular syndrome. Technical innovations like videooculography and vestibular evoked myogenic potentials enable us to selectively and side-specifically examine the function of all six semicircular canals and two otolith organs. Pathomechanism of disorders with vertigo and dizziness became more clear resulting in the development or amendment of diagnostic criteria of several vestibular disorders including vestibular migraine, Menière’s disease, benign paroxysmal positional vertigo, persistent postural-perceptual dizziness, bilateral vestibulopathy. Broader knowledge about the pathomechanism promoted the development of new therapeutic methods like different repositioning maneuvers in benign paroxysmal positional vertigo, pharmaceutical therapies, vestibular rehabilitation, and psychotherapy. We aimed to summarize the novelties in the field of oto-neurology.]