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Cytotherapy Aug 2023The most clinically trialed cells, mesenchymal stromal cells (MSCs), are now known to mainly exert their therapeutic activity through paracrine secretions, which include...
The most clinically trialed cells, mesenchymal stromal cells (MSCs), are now known to mainly exert their therapeutic activity through paracrine secretions, which include exosomes. To mitigate potential regulatory concerns on the scalability and reproducibility in the preparations of MSC exosomes, MSC exosomes were produced using a highly characterized MYC-immortalized monoclonal cell line. These cells do not form tumors in athymic nude mice or exhibit anchorage-independent growth, and their exosomes do not carry MYC protein or promote tumor growth. Unlike intra-peritoneal injections, topical applications of MSC exosomes in a mouse model of IMQ-induced psoriasis alleviate interleukin (IL)-17, IL-23 and terminal complement complex, C5b9 in psoriatic skin. When applied on human skin explants, fluorescence from covalently labeled fluorescent MSC exosomes permeated and persisted in the stratum corneum for about 24 hours with negligible exit out of the stratum corneum into the underlying epidermis. As psoriatic stratum corneums are uniquely characterized by activated complements and Munro microabscesses, we postulated that topically applied exosomes permeate the psoriatic stratum corneum to inhibit C5b9 complement complex through CD59, and this inhibition attenuated neutrophil secretion of IL-17. Consistent with this, we demonstrated that assembly of C5b9 on purified human neutrophils induced IL-17 secretion and this induction was abrogated by MSC exosomes, which was in turn abrogated by a neutralizing anti-CD 59 antibody. We thus established the mechanism of action for the alleviation of psoriatic IL-17 by topically applied exosomes.
Topics: Animals; Mice; Humans; Exosomes; Interleukin-17; Mice, Nude; Reproducibility of Results; Psoriasis; Mesenchymal Stem Cells
PubMed: 37115163
DOI: 10.1016/j.jcyt.2023.03.015 -
Microorganisms Mar 2024Systemic infection, also known as cat-scratch disease (CSD), presents a diagnostic challenge due to the variability of clinical manifestations and the potential for...
Systemic infection, also known as cat-scratch disease (CSD), presents a diagnostic challenge due to the variability of clinical manifestations and the potential for serological cross-reactivity with other organisms. This study aimed to retrospectively analyze the epidemiological, clinical, laboratory, and imaging characteristics of pediatric patients diagnosed with systemic infection, to improve understanding and facilitate timely diagnosis and treatment. We conducted a 10-year retrospective study at the "Louis Turcanu" Children's Emergency Hospital and private clinics in Timisoara, Romania, reviewing records for confirmed cases of infection from January 2014 to January 2024. The study adhered to the Declaration of Helsinki and received approval from the Institutional Review Board. Diagnostic criteria included contact with animals, prolonged fever, hematological and/or hepatosplenic manifestations, and positive serological tests for . Nineteen pediatric patients were identified with a median age of 8.1 years. The majority were exposed to felines (94.7%), reflecting the disease's epidemiological profile. Clinical findings highlighted fever (47.4%), lymphadenopathy (78.9%), and less frequently, abdominal pain and headache (both 10.5%). Laboratory analyses revealed a mean hemoglobin of 12.6 mg/dL, WBC count of 13.1 × 10 cells/microliter, and platelet count of 340.6 × 10 per microliter. Significant findings included elevation in ESR and CRP in 47.4% and 21.1% of patients, respectively, and high seropositivity rates for IgM (63.2%) and IgG (94.7%). Imaging studies demonstrated widespread lymphadenopathy and occasional splenomegaly and hepatic microabscesses. All patients received antibiotic therapy, with azithromycin being the most commonly used (94.7%). Co-infections with Epstein-Barr Virus, Cytomegalovirus, and were documented, indicating the complex infectious status of the patients. Systemic infection in children predominantly manifests with fever and lymphadenopathy, with a significant history of exposure to felines. Laboratory and imaging findings support the diagnosis, which is further complicated by potential co-infections. Effective antibiotic therapy, primarily with azithromycin, underscores the need for comprehensive diagnostic and treatment strategies. This study emphasizes the importance of considering systemic infection in pediatric patients with prolonged fever and contact with cats, to ensure timely and appropriate treatment.
PubMed: 38674610
DOI: 10.3390/microorganisms12040666 -
Cureus Nov 2023Primary hyperparathyroidism (PHPT) is characterized by an elevation in serum calcium levels, sometimes leading to aggravated clinical conditions, namely nephrolithiasis,...
Primary hyperparathyroidism (PHPT) is characterized by an elevation in serum calcium levels, sometimes leading to aggravated clinical conditions, namely nephrolithiasis, nephrocalcinosis, and/or fractures. A 55-year-old patient was admitted to the hospital with acute obstructive pyelonephritis in March 2021, having another episode one year later. Initial blood and urine analysis detected inflammatory markers, namely C-reactive protein, and the presence of leucocytes and blood in the urine. The renal computed tomography scan exhibited renal asymmetry, nephrocalcinosis, and multiple kidney stones. The patient was scheduled for a follow-up one year later to perform blood and urine analysis to uncover the cause of nephrocalcinosis, displaying high serum calcium and parathyroid hormone (PTH) levels. The thyroid ultrasound revealed a parathyroid adenoma, which was removed through a right lower parathyroidectomy, improving the symptoms. The clinical condition described here is an atypical manifestation of this disease because PHPT is normally asymptomatic. In the present case study, nephrocalcinosis and nephrolithiasis were strong indicators of the underlying disease. However, the delay in the follow-up consultation resulted in complications for the patient, such as microabscesses in the kidneys, which could lead to reduced renal function in the future. Early detection of key aspects of the disease could avoid further complications and suffering for the patient. For example, the family physician's follow-up of the patient's condition could surpass the waiting time between consultations with different specialties, and promote early treatment.
PubMed: 38146580
DOI: 10.7759/cureus.49383 -
Access Microbiology 2023has been known to cause a variety of clinical manifestations ranging from mild enteric illness to bacteraemia with septic shock and extraintestinal abscesses. Patients...
INTRODUCTION
has been known to cause a variety of clinical manifestations ranging from mild enteric illness to bacteraemia with septic shock and extraintestinal abscesses. Patients with liver disease and iron overload are at risk of more severe disease manifestations.
CASE REPORT
A middle-aged male with chronic alcohol use disorder presented with confusion and jaundice, with ascites and asterixis noted on examination. His blood work was remarkable for neutrophilic leukocytosis, elevated liver enzymes and lactate. An abdominal computed tomography scan revealed splenic microabscesses and a cirrhotic liver. was recovered from his blood cultures and he was treated with ceftriaxone following susceptibility results.
CONCLUSION
should be considered in the differential diagnosis of splenic or other extraintestinal microabscesses particularly in patients with chronic liver disease.
PubMed: 37841094
DOI: 10.1099/acmi.0.000525.v3 -
Langenbeck's Archives of Surgery Aug 2023Weighing the perioperative risk of elective sigmoidectomy is done regardless of the specific diverticulitis classification. The aim of this study is to evaluate surgical...
OBJECTIVE
Weighing the perioperative risk of elective sigmoidectomy is done regardless of the specific diverticulitis classification. The aim of this study is to evaluate surgical outcomes according to the classification grade and the indication.
METHODS
All patients who underwent elective colonic resection for diverticulitis during the ten-year study period were included. They were divided into two groups: relative surgery indication (RSI) and absolute surgery indication (ASI). RSI included microabscess and recurrent uncomplicated disease. ASI included macroabscess and recurrent complicated disease. Propensity score-matching (PSM, 1:1) was performed.
RESULTS
585 patients fulfilled criteria for RSI and 318 patients fulfilled criteria for ASI. In the univariate analysis, RSI patients were younger (62 vs. 67.7 years, p < 0.001), had a higher physical status (ASA score 1 or 2 in 80.7% vs. 60.8%, p < 0.001), were less immunosuppressed (3.4% vs. 6.9%, p = 0.021) and suffered less often from coronary heart disease (3.8% vs. 7.2%, p = 0.025). After PSM, 318 RSI vs. 318 ASI patients were selected; baseline characteristics results were comparable. The proportion of planned laparoscopic resection was 93% in RSI versus 75% in ASI (p < 0.001), and the conversion rate to open surgery for laparoscopic resection was 5.0% and 13.8% in RSI versus ASI, respectively (p < 0.001). Major morbidity (Clavien/Dindo ≥ IIIb) occurred less frequently in RSI (3.77% vs. 10%, p = 0.003). A defunctioning stoma was formed in 0.9% and 11.0% in RSI vs ASI, respectively (p < 0.001).
CONCLUSION
The lower risk for postoperative morbidity, the higher chance for a laparoscopic resection and the decreased rate of stoma formation are attributed to patients with recurrent uncomplicated diverticulitis or diverticulitis including a microabscess as compared to patients with complicated diverticulitis or diverticulitis and a macroabscess, and this applies even after PSM.
Topics: Humans; Cohort Studies; Diverticulitis, Colonic; Propensity Score; Diverticulitis; Colon, Sigmoid; Laparoscopy; Elective Surgical Procedures; Abscess; Treatment Outcome
PubMed: 37535118
DOI: 10.1007/s00423-023-03034-9 -
Revista Da Sociedade Brasileira de... 2023
Topics: Humans; Aspergillus; Encephalitis; Abscess; Immunocompetence
PubMed: 37792845
DOI: 10.1590/0037-8682-0391-2023 -
Veterinary Immunology and... Jul 2023Ovine brucellosis is an infectious disease that causes alterations in the reproductive tract in ram and abortion in ewes. Their negative economic impact in ovine...
Ovine brucellosis is an infectious disease that causes alterations in the reproductive tract in ram and abortion in ewes. Their negative economic impact in ovine production warrants a thorough understanding the interactions between B. ovis and the host. Here, epididymis lesions of rams infected by B. ovis were histopathologically staged into early and advanced. Expression by immunohistochemistry of Brucella antigens, inflammatory cell markers (CD3, CD79αcy) and cytokines (IFN-γ, TNF-α, TGF-β1) was assessed in both stages. Early lesions were characterized by epithelial changes, interstitial inflammation, and mild fibrosis; whereas advanced lesions displayed caseous granulomas containing numerous macrophages, multinucleated giant cells, lymphocytes, and plasma cells. Expression of Brucella antigens were observed in both stages. The cellular response in B. ovis lesions were predominantly of T-cells (CD3+) whereas low numbers of B-cells and plasma cells (CD79αcy+) were present in both early and advanced lesions. IFN-γ was expressed by lymphocytes in early lesions suggesting that the adaptive immune response against B. ovis is initiated by Th1 cells, this response was also preserved in advanced stages. Expression of TNF-α was observed in neutrophils of epithelial microabscesses and intraepithelial T-cells of early lesions suggesting a promotion of neutrophil phagocytosis triggered by TNF-α. On the other hand, advanced lesions showed a reduction of TNF-α expression which may permit B. ovis persistence in granulomas. Lastly, TGF-β1 expression (fibroblast, macrophages and less in lymphocytes) were increased with time, suggesting that B. ovis promotes TGF-β1 secretion promoting chronicity of the lesions.
Topics: Sheep; Animals; Male; Female; Epididymis; Brucella ovis; Transforming Growth Factor beta1; Tumor Necrosis Factor-alpha; Sheep Diseases; Brucellosis; Sheep, Domestic
PubMed: 37348444
DOI: 10.1016/j.vetimm.2023.110621 -
Annals of Medicine and Surgery (2012) Nov 2023Chronic eosinophilic pneumonia (CEP) is an idiopathic condition characterized by unusually high eosinophil infiltration in the lungs' interstitium and alveolar spaces....
INTRODUCTION AND IMPORTANCE
Chronic eosinophilic pneumonia (CEP) is an idiopathic condition characterized by unusually high eosinophil infiltration in the lungs' interstitium and alveolar spaces. It is extremely rare, accounting for fewer than 3% of all interstitial lung diseases. CEP is frequently misdiagnosed as lung cancer, which can have catastrophic consequences for sufferers. When assessing patients with lung disease, doctors should be aware of CEP's symptoms and take its prognosis into account because it is a curable disorder.
CASE PRESENTATION
A 40-year-old female presented in the outpatient department of gynecology with a history of abnormal vaginal bleeding for 3 months and mild shortness of breath without any other significant medical history or being under any medications. Physical examination findings were not significant.
CLINICAL DISCUSSION
Ultrasound revealed adenomyosis and a hysterectomy was planned. Chest radiograph revealed lung mass and computed tomography scan showed a well-defined mass with a pleural-based nodule. Histopathology revealed interstitial fibrosis and eosinophilic microabscesses. CEP was diagnosed and oral prednisolone was started with a 0.5 mg/kg/day dose. Chest radiographic abnormalities resolved after one month of treatment. Currently, she is asymptomatic.
CONCLUSION
Early recognition and diagnosis of lung masses are essential for prompt treatment with corticosteroids. CEP can mimic lung malignancy and should be considered in patients with related symptoms.
PubMed: 37915693
DOI: 10.1097/MS9.0000000000001296 -
Clinical, Cosmetic and Investigational... 2023We present the case of a 37-year-old male diagnosed with Mycosis fungoides (MF) after gradually developing multiple skin tags and brownish lichenoid papules. The patient...
We present the case of a 37-year-old male diagnosed with Mycosis fungoides (MF) after gradually developing multiple skin tags and brownish lichenoid papules. The patient had pre-existing erythema over his entire body, especially his face, upper extremities, and trunk, for over 1.5 years. Microscopic examination of the papule and the skin tag (ST) exhibited similar features mainly characterized by superficial dense band-like lymphoid infiltrates and epidermotropism of atypical lymphocytes (Pautrier's micro-abscesses). Immunohistochemistry further revealed the lymphoid infiltrates predominantly expressed LCA, CD3, CD4, and CD45RO but lacked CD7, CD8, CD30, CD20, and CD79a. The finding of this study that reports MF characterized by unusual STs suggests that some causes and effects have not been previously described in MF.
PubMed: 37441694
DOI: 10.2147/CCID.S411041