Background: Systemic secondary amyloidosis (SSA) is associated with chronic inflammatory disorders and/or chronic infections. Patients and Methods: Over the past 10 years;a total of 21 patients, with long-term (17 mon...Background: Systemic secondary amyloidosis (SSA) is associated with chronic inflammatory disorders and/or chronic infections. Patients and Methods: Over the past 10 years;a total of 21 patients, with long-term (17 months) and extensive psoriasis (P) with psoriasis area severity index (PASI) >29, were evaluated. Results: Two patients had nephrotic syndrome (proteinuria 3.9 and 3.6 g/day) and decrease creatinine clearance (46 and 62 ml/minute). Their renal biopsy revealed Congo-red (+) nodular glomerulosclerosis that lacked immune-deposits and resisted wash with K-permanganate wash indicating SSA. Three months subsequent to Cyclosporin A (CyA) therapy with 100 mg twice daily;psoriasis improved in all patients with decrease in (PASI) from 29.5 to 3.5 1. In the 2 patients with SSA;proteinuria decreased to 2.1 and 1.8 g/day and creatinine clearance improved to 51 and 69 ml/minute. Such improvement persisted up to 2 years of follow up and up to 78 months in patients with SSA. Conclusion: psoriasis-induced SSA is an autoimmune disease, with genetic predisposition that is amenable to CyA therapy.展开更多
为了解crp/cya基因对鸡白痢沙门菌毒力和生物学特性的影响,本研究构建缺失1182 bp cya基因的重组自杀性质粒pREΔcya,并经酶切和测序鉴定正确后,转化大肠杆菌χ7213作为供体菌,分别以鸡白痢沙门菌C79-13株和本研究室前期构建的其crp基...为了解crp/cya基因对鸡白痢沙门菌毒力和生物学特性的影响,本研究构建缺失1182 bp cya基因的重组自杀性质粒pREΔcya,并经酶切和测序鉴定正确后,转化大肠杆菌χ7213作为供体菌,分别以鸡白痢沙门菌C79-13株和本研究室前期构建的其crp基因缺失株C79-13Δcrp(简写为Δcrp)为受体菌,利用重组自杀性质粒介导的同源重组技术构建C79-13菌株的单基因缺失株Δcya以及双基因缺失株ΔcrpΔcya,并均经PCR和测序鉴定。将这3株菌连续传60代后每隔10代分别利用PCR鉴定cya基因缺失的遗传稳定性;利用玻片凝集试验鉴定各菌株的血清型,并鉴定各菌株的生化反应特性;绘制各菌株的生长曲线分析缺失株与亲本株的生长特性;通过微量结晶紫法检测各菌株的生物被膜(BF)形成能力。PCR和测序鉴定结果显示Δcya、ΔcrpΔcya均正确构建,且cya基因缺失均具有稳定的遗传性。血清型及生化鉴定结果显示,菌株Δcya、Δcrp、ΔcrpΔcya均保留了C79-13的O9血清型,而失去了发酵蔗糖、鼠李糖、葡萄糖、麦芽糖等糖类的能力。生长曲线及BF形成能力的检测结果显示,各缺失株的生长速度较亲本株相比均显著降低,尤其双基因缺失株ΔcrpΔcya的生长速度极显著下降(P<0.01),且基因缺失株BF的形成能力均极显著降低(P<0.01),其中双基因缺失株BF的形成能力更低。将3株缺失菌及亲本菌分别以不同的剂量(5×10^(8)cfu/只~7×10^(11)cfu/只)经腹腔注射感染雏鸡进行毒力试验,计算各菌株对雏鸡的半数致死量(LD_(50))。将各缺失株以10^(7) cfu/mL两次经灌服免疫雏鸡,100μL/只,二免后7 d各组雏鸡均以5.0×10^(8)cfu/mL经腹腔注射亲本菌株C79-13进行攻毒试验,500μL/只,在42 d的观察期内观察并记录各组鸡的发病及死亡情况,计算各基因缺失株对雏鸡的免疫保护率。结果显示,缺失株Δcya、Δcrp、ΔcrpΔcya对雏鸡的LD_(50)分别为2.84×10^(9) cfu/mL、1.41×10^(10)cfu/mL、2.51×10^(11)cfu/mL,与亲本菌株C79-13相比,各缺失株LD_(50)分别升高约1.1×10^(3)倍、5.7×10^(3)倍、1.0×10^(5)倍;各组雏鸡攻毒后出现精神沉郁症状,且有部分鸡死亡,PBS对照组鸡出现排稀便症状,且全部死亡。Δcya、Δcrp及ΔcrpΔcya对雏鸡的免疫保护率分别为60%、80%、50%。表明各基因缺失株均能够对雏鸡提供一定的免疫保护效果,且单基因缺失株Δcrp的免疫效果最好。本研究首次对鸡白痢沙门菌crp、cya基因生物学功能做了初步研究,并证实缺失株Δcrp有望作为一种鸡白痢沙门菌基因缺失疫苗的候选菌株,为研制安全有效的沙门菌弱毒活疫苗奠定了基础。展开更多
Renal transplant patients receive several immunosuppressive drug regimens that are potentially nephrotoxic for treatment.Serum creatinine is the standard for monitoring kidney function;however,cystatin C(Cys C)and kid...Renal transplant patients receive several immunosuppressive drug regimens that are potentially nephrotoxic for treatment.Serum creatinine is the standard for monitoring kidney function;however,cystatin C(Cys C)and kidney injury molecule-1(KIM-1)have been found to indicate kidney injury earlier than serum creatinine and provide a better reflection of kidney function.Here,we assessed Cys C and KIM-1 serum levels in renal transplant patients receiving mycophenolate mofetil,tacrolimus,sirolimus,everolimus,or cyclosporine to evaluate kidney function.We used both the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)2021 equation,which is based on creatinine and combined creatinine with Cys C,and the CKD-EPI 2012 equation,which is based on Cys C alone,to estimate glomerular filtration rate(GFR).Then,we assessed the association between serum KIM-1 and GFR<90 mL per minute per 1.73 m2.We observed significantly higher serum Cys C levels in patients with the elevated serum creatinine,compared with those with normal serum creatinine.The estimated GFRs based on creatinine were significantly higher than those based on the other equations,while a significant positive correlation was observed among all equations.Serum KIM-1 levels were negatively correlated with the estimated GFRs by the CKD-EPI Cys C and the combined creatinine with Cys C equations.A serum KIM-1 level above 0.71 ng/mL is likely to indicate GFR<90 mL per minute per 1.73 m2.We observed a significant correlation between serum creatinine and Cys C in our renal transplant patients.Therefore,serum KIM-1 may be used to monitor renal function when using potentially nephrotoxic drugs in renal transplants.展开更多
文摘Background: Systemic secondary amyloidosis (SSA) is associated with chronic inflammatory disorders and/or chronic infections. Patients and Methods: Over the past 10 years;a total of 21 patients, with long-term (17 months) and extensive psoriasis (P) with psoriasis area severity index (PASI) >29, were evaluated. Results: Two patients had nephrotic syndrome (proteinuria 3.9 and 3.6 g/day) and decrease creatinine clearance (46 and 62 ml/minute). Their renal biopsy revealed Congo-red (+) nodular glomerulosclerosis that lacked immune-deposits and resisted wash with K-permanganate wash indicating SSA. Three months subsequent to Cyclosporin A (CyA) therapy with 100 mg twice daily;psoriasis improved in all patients with decrease in (PASI) from 29.5 to 3.5 1. In the 2 patients with SSA;proteinuria decreased to 2.1 and 1.8 g/day and creatinine clearance improved to 51 and 69 ml/minute. Such improvement persisted up to 2 years of follow up and up to 78 months in patients with SSA. Conclusion: psoriasis-induced SSA is an autoimmune disease, with genetic predisposition that is amenable to CyA therapy.
基金Part of the consumables used in the present study was obtained as a part of funding of a research study from College of Medicine and Medical Sciences,Arabian Gulf University(Grant No.G05/AGU-11/19).
文摘Renal transplant patients receive several immunosuppressive drug regimens that are potentially nephrotoxic for treatment.Serum creatinine is the standard for monitoring kidney function;however,cystatin C(Cys C)and kidney injury molecule-1(KIM-1)have been found to indicate kidney injury earlier than serum creatinine and provide a better reflection of kidney function.Here,we assessed Cys C and KIM-1 serum levels in renal transplant patients receiving mycophenolate mofetil,tacrolimus,sirolimus,everolimus,or cyclosporine to evaluate kidney function.We used both the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)2021 equation,which is based on creatinine and combined creatinine with Cys C,and the CKD-EPI 2012 equation,which is based on Cys C alone,to estimate glomerular filtration rate(GFR).Then,we assessed the association between serum KIM-1 and GFR<90 mL per minute per 1.73 m2.We observed significantly higher serum Cys C levels in patients with the elevated serum creatinine,compared with those with normal serum creatinine.The estimated GFRs based on creatinine were significantly higher than those based on the other equations,while a significant positive correlation was observed among all equations.Serum KIM-1 levels were negatively correlated with the estimated GFRs by the CKD-EPI Cys C and the combined creatinine with Cys C equations.A serum KIM-1 level above 0.71 ng/mL is likely to indicate GFR<90 mL per minute per 1.73 m2.We observed a significant correlation between serum creatinine and Cys C in our renal transplant patients.Therefore,serum KIM-1 may be used to monitor renal function when using potentially nephrotoxic drugs in renal transplants.
