Hungarian Immunology

[Natural immunity]

SZEGEDI Gyula

JANUARY 30, 2006

Hungarian Immunology - 2006;5(01)

COMMENTS

0 comments

Further articles in this publication

Hungarian Immunology

[Regional cues and phenotypic responses during the ontogeny and postnatal development of splenic vasculatur]

BALOGH Péter

[Among structured peripheral lymphoid tissues in man and rodents, the spleen demonstrates the most extensive flexibility in functional activities, which is coupled with considerable tissue architecture adjustments during ontogeny and immune reactions. The sequential conversion of a primary lymphohemopoietic tissue into a major peripheral lymphoid organ (while participating in the post-myeloid period of primary B-lymphopoiesis and retaining the potential for myelopoiesis) is accompanied with the ordered segregation involving various non-hemopoietic components of architecture, including the endothelia of blood vessels. In this report we will survey the functional and structural aspects of heterogeneous endothelial cells lining the various splenic vascular beds, comprising the complex circulatory network of the spleen. These features will be correlated with the characteristics of those regulatory mechanisms that have recently been demonstrated to be responsible for the establishment and maintenance of the endothelial divergence during splenic vascular development, including crucial transcription factors, morphogenic regulatory ligands and receptors of the tumor necrosis factor/lymphotoxin (TNF/LT) family and others. The influence of these regulatory elements in mice appears to be highly restricted in terms of regional involvement of the vasculature, with cellular alterations of the marginal sinus representing the most frequently affected region. This complexity highlights the importance of this tissue region in both the formation of splenic vasculature and a possible source for white pulp stromal elements as well as its function as a major gateway for lymphocyte traffic.]

Hungarian Immunology

[Congress of the American College of Rheumatology, 2005]

SZŰCS Gabriella, SZÁNTÓ Sándor

Hungarian Immunology

[Primer and transitory defects of interferonactivated pathways]

ERDŐS Melinda, MARÓDI László

Hungarian Immunology

[Antiphospholipid syndrome - focused on the childhood form]

KÁLOVICS Tamás, PONYI Andrea, BENSE Tamás, MÜLLER Judit, DANKÓ Katalin, FEKETE György, CONSTANTIN Tamás

[Antiphospholipid syndrome is an autoimmune disorder characterized by recurrent thromboembolic events with concurrent presence of antiphospholipid antibodies in the sera. The morbidity and mortality of the syndrome is defined by the clinical manifestations: deep vein thrombosis, cerebrovascular events, myocardial infarct, pulmonary embolism, recurrent pregnancy losses and prematurity. The authors reviewed the pathogenesis, the clinical course and the treatment of the antiphospholipid syndrome focused on the childhood form.]

Hungarian Immunology

[Mutations of La gene: the proper reaction of the immune system]

SEMSEI Imre

[Numerous hypotheses have emerged to solve the problem and the pathomechanism of autoimmunity so far. Different factors are suspected, from viruses to neuroendocrine elements, to be a pathogen in the etiology of autoimmune diseases. Most of the theories are based on the assumption that something happens to the immune system and it leads to an autoimmune reaction against the proper self. This paper indicates that, at least in certain cases, the immune system reacts properly against the altered cells; therefore the cause of the autoimmunity lies in the other improper functioning of the body. Experimental data show that La autoantigen plays a role not only as a diagnostic marker but it may participate in the pathomechanism of certain autoimmune diseases as well. Mutations in the exon 7 of La gene have such consequences that could lead to the formation of autoimmune reactions detected.]

All articles in the issue

Related contents

Lege Artis Medicinae

[Coronavirus disease-2019 among rheumatic musculoskeletal patients – possible outcomes of infection, severe disease development and effectiveness of vaccination]

HODINKA László

[The prevalence of coronavirus infection of patients with inflammatory and rheumatic diseases does not differ significantly from the rate of the disease in the local general population. Patients treated with higher doses of corticosteroids, especially those with more severe systemic autoimmune disease, contract coronavirus infection at a higher rate. The risks of hospitalisation and the mortality rate do not differ significantly from those of the general COVID infected population. Patients treated with high-dose corticosteroids and cytostatic drugs are exceptions of this. Associated diseases that are generally threatening the COVID-19 patients (according to pre-COVID rheumatology surveys) are the same in inflammatory and non-inflammatory rheumatology conditions. Hence, the risk of severe COVID-19 outcome does not essentially depend on rheumatological conditions since the aging itself with typical cardiopulmonary and metabolic diseases are also responsible for. From the treatment armamentarium of inflammatory rheumatology/autoimmune diseases only arbitrarily dosed dexamethasone treatment seems efficacious. In specific patient groups, interleukin 6 antagonists and JAK inhibitors may also have a beneficial effect. The rheumatological and autoimmune drugs as antimetabolites, anti-cytokine immunotherapies and JAK inhibitors, do not increase the risk of COVID-19 infection since it is not necessary to stop them in infected pa­tients. The B-cell antagonist rituximab is the exception since by attenuating humoral immunity and the presence of active disease increase the risk of severe outcome in COVID-19 infected cases. COVID vaccination does not mean specific acute risk for rheumatological and autoimmune patients. The long term effect of COVID vaccination regarding the robustness and sustained immunity specifically in autoimmune and inflammatory diseases needs further studies.]

Clinical Neuroscience

[Radiosurgery of intracerebral cavernomas - Current Hungarian practice]

FEDORCSÁK Imre, NAGY Gábor, DOBAI József Gábor, MEZEY Géza, BOGNÁR László

[Background and purpose - Radiosurgery is an increasingly popular treatment option especially for deep eloquent intracerebral cavernomas that are often too risky for surgical removal, but their re-bleed carries significant risk for persisting neurological deficit. Gamma-radiation based radiosurgery has been being available since 2007 in Hungary in Debrecen. Our aim is to summarize our experience accumulated during the first five years of treatment and to compare it to the international experience. Patient selection and methods - We retrospectively analyzed 51 cavernomas in 45 patients treated between 2008 and 2012 in terms of localization, natural history, and the effect of radiosurgery on re-bleed risk and epilepsy, and its side effects. Results - We treated 26.5% deep eloquent (brainstem, thalamic/basal ganglia) and 72.5% superficial hemispheric cavernomas. The median presentation age was 25 years (13-60) for deep, and 45 years (6-67) for superficial cavernomas. They were treated median of 1 year after presentation. 64.5% of deep cavernomas bled before treatment, the annual risk of first hemorrhage was 2%/lesion, re-bleed risk 21.7%, with 44% persisting morbidity. 13.5% of superficial cavernomas bled prior to treatment, the risk of first bleed was 0.3%, there was no re-bleed, and 35% caused epilepsy. We used GammaART-6000TM rotating gamma system for treatment, marginal dose was 14 Gy (10-16), and treatment volume 1.38-1.53 cm3. Re-bleed risk of deep eloquent lesions fell to 4% during the first two years after treatment and to 0% thereafter, and no hemorrhage occurred from superficial lesions after treatment. Persisting morbidity in deep lesions came from adverse radiation effect in 7% and from re-bleed in 7%, and there was no persisting side effect in superficial cavernomas. 87.5% of cases of epilepsy resistant to medical therapy improved. Radiological regression was found in 37.5% and progression in 2% after treatment. Conclusions - Radiosurgery of cavernomas is safe and effective. Early preventive treatment for deep cavernomas carrying high surgical risk is justified. Moreover, for superficial lesions that are surgically easily accessible radiosurgery also appears to be an attractive alternative.]

Clinical Neuroscience

Can high uric acid levels be an independent risk factor for acute ischemic stroke due to large-artery atherosclerosis?

ACAR Türkan, ARAS Guzey Yesim, GÜL Sinem Sidika, ACAR Atılgan Bilgehan

Introduction - Uric acid is a molecule that is known to act as a natural antioxidant in acute oxidative stress conditions such as acute ischemic stroke (AIS). Although there are several studies on the prognostic value of serum uric acid (UA) level, especially the AIS, its importance in ischemic stroke is still controversial. Our aim in this study is to investigate whether the serum UA level is an indicative biomarker in the large-artery atherosclerosis in the AIS etiology. Material and method - Of the patients admitted to Sakarya University Training and Research Hospital Depart-ment of Neurology between January 2017 and November 2017, 91 hospitalized patients, who had AIS diagnosis and had their uric acid levels measured, were analyzed retrospectively. Patients with diabetes mellitus (DM), hypertension (HT), smoking habit, obesity, gout, hyperlipidemia (HL) and renal failure were excluded from the study. Patients were classified as anterior system and posterior system infarct. Then, patients were divided into two groups, one with internal carotid artery (ICA) > 50% stenosis and the other with ICA < 50% stenosis according to carotid-vertebral artery doppler USG examination performed for etiology. Serum UA, total bilirubin, direct bilirubin and indirect bilirubin levels of both groups were statistically compared. Results - In the comparison of serum UA values of ICA>50% stenosis and ICA<50% stenosis group of AIS patients, a statistically significant difference was found between the UA levels (p<0.000), but there was no difference between total bilirubin, direct bilirubin and indirect bilirubin values (p>0.05). Conclusion - High uric acid levels can be considered an independent, indicative risk factor for large-artery disease in AIS.

Lege Artis Medicinae

[Mechanism of mucosal defence and options to reduce virus invasion during the COVID pandemic]

HODINKA László

[The portal of entry for coronavirus is the mucous membrane of the respiratory tract. Severity, organ manifestations and out­come of COVID-19 are determined by the viral load, burdening the attacked organism. Condition of the respiratory tract and gastrointestinal mucosa and the capacity of their defence system are crucial for virus penetration, fusion with epithelial cells and replication. Direct neural spread, penet­ra­tion into the deeper airways and spread through the lymph nodes depend on these functions. Virus binding and engulfment is an active process. The virus penetrates the endosomes of the epithelial cell, by enzymatic transfer where it is recognised by natural defence agents and triggers the first defence responses. These alarm the entire immune system and trigger a whole chain of inflammatory and enzymatic defence processes (cytokine and bradykinin storm) proportional to the viral load. The severity endpoint of COVID-19 pathology is alveolitis, cerebral vasculitis and intestinal da­mage, often with fatal outcome. The airway mucosa defends itself by secreting surface factors and recruiting and activating cells of the adaptive immune system. An important element of the latter is the early ap­pearance of secretory IgA in the mucosa. The viral invasion can be prevented by application of a nasal spray containing carrageenan, which engages the virus and prevents its attachment by the gel-forming property of carrageenan. This effect has worked in previous virus epidemics and the first COVID-19 experiences confirm its pro­tec­tive role. ]

Hypertension and nephrology

[Cholesterol-lowering is not the Holy Grail, but neither is the work of the devil]

BAJNOK László

[Cholesterol-lowering statins are the most tested medications in respect of the effects and side-effects. Based on these, we can safely claim that most of the negative opinions about cholesterol-lowering are not realistic. It is not a panacea, but it is proven that around a 30% of cardio- and cerebrovascular risk reducation can be achieved by their regular taking, while the incidence of side effects and risks are at least one order of magnitude lower in each patient groups. For cholesterol, there is no “normal” lab threshold or low level, only “target values”, since the mean value in the general population is high in regard of atherosclerosis (the values measured at birth and among natural people can be considered normal). Let us appreciate the cholesterol- lowering medications because we do not have a large armamentarium!]