| 46341. |
- Heijstek, M W, et al.
(författare)
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EULAR recommendations for vaccination in paediatric patients with rheumatic diseases.
- 2011
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 70:10, s. 1704-12
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Tidskriftsartikel (refereegranskat)abstract
- Evidence-based recommendations for vaccination of paediatric patients with rheumatic diseases (PaedRD) were developed by following the EULAR standardised procedures for guideline development. The EULAR task force consisted of (paediatric) rheumatologists/immunologists, one expert in vaccine evaluation, one expert in public health and infectious disease control, and one epidemiologist. A systematic literature review was conducted in MEDLINE, EMBASE, and abstracts of the EULAR and American College of Rheumatology meetings of 2008/9. The level of evidence and strength of recommendation were based on customary scoring systems. Delphi voting was applied to assess the level of agreement between task force members. 107 papers and eight abstracts were used. The majority of papers considered seasonal influenza (41) or pneumococcal (23) vaccination. 26 studies were performed specifically in paediatric patients, and the majority in adult rheumatoid arthritis and systemic lupus erythematosus patients. Fifteen recommendations were developed with an overall agreement of 91.7%. More research is needed on the safety and immunogenicity of (live-attenuated) vaccination in PaedRD, particularly in those using biologicals, and the effect of vaccination on prevention of infections.
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| 46342. |
- Heijstek, M W, et al.
(författare)
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Vaccination in paediatric patients with auto-immune rheumatic diseases: A systemic literature review for the European League against Rheumatism evidence-based recommendations.
- 2011
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Ingår i: Autoimmunity reviews. - : Elsevier BV. - 1873-0183 .- 1568-9972. ; 11:2, s. 112-122
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To analyze available evidence on vaccinations in paediatric patients with rheumatic and autoinflammatory diseases. This evidence formed the basis of the recently constructed European League against Rheumatism (EULAR) recommendations for vaccination of these patients. METHODS: A systematic literature review in the MEDLINE and EMBASE databases was conducted using various terms for vaccinations, paediatric rheumatic and autoinflammatory diseases and immunosuppressive drugs. Only papers on paediatric patients (<18years of age) were selected. A panel of 13 experts in the field graded methodological quality and extracted data using predefined criteria. RESULTS: 27 papers were available. No studies were found on autoinflammatory diseases. 14 studies considered live-attenuated vaccines. Evidence so far supports the safety and immunogenicity of non-live composite vaccines, although studies were underpowered to accurately assess safety. Live-attenuated vaccines did not cause disease flares or severe adverse events, not even in patients on methotrexate and low dose glucocorticosteroids. Seven patients on anti-TNFalpha therapy were described receiving the live-attenuated measles, mumps, rubella (n=5) or varicella (n=2) booster without severe adverse events. CONCLUSIONS: Data on safety and efficacy of vaccinations in paediatric patients with rheumatic diseases is reassuring, but too limited to draw definite conclusions. More research is needed on the safety and efficacy of especially live-attenuated vaccines in patients with rheumatic and autoinflammatory diseases using high dose immunosuppressive drugs.
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| 46343. |
- Heikkila, K., et al.
(författare)
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Job strain and the risk of severe asthma exacerbations : a meta-analysis of individual-participant data from 100 000 European men and women
- 2014
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : Wiley. - 0105-4538 .- 1398-9995. ; 69:6, s. 775-783
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMany patients and healthcare professionals believe that work-related psychosocial stress, such as job strain, can make asthma worse, but this is not corroborated by empirical evidence. We investigated the associations between job strain and the incidence of severe asthma exacerbations in working-age European men and women. MethodsWe analysed individual-level data, collected between 1985 and 2010, from 102 175 working-age men and women in 11 prospective European studies. Job strain (a combination of high demands and low control at work) was self-reported at baseline. Incident severe asthma exacerbations were ascertained from national hospitalization and death registries. Associations between job strain and asthma exacerbations were modelled using Cox regression and the study-specific findings combined using random-effects meta-analyses. ResultsDuring a median follow-up of 10years, 1 109 individuals experienced a severe asthma exacerbation (430 with asthma as the primary diagnostic code). In the age- and sex-adjusted analyses, job strain was associated with an increased risk of severe asthma exacerbations defined using the primary diagnostic code (hazard ratio, HR: 1.27, 95% confidence interval, CI: 1.00, 1.61). This association attenuated towards the null after adjustment for potential confounders (HR: 1.22, 95% CI: 0.96, 1.55). No association was observed in the analyses with asthma defined using any diagnostic code (HR: 1.01, 95% CI: 0.86, 1.19). ConclusionsOur findings suggest that job strain is probably not an important risk factor for severe asthma exacerbations leading to hospitalization or death.
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| 46344. |
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| 46345. |
- Heinrich, A, et al.
(författare)
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Moraxella catarrhalis induces CEACAM3-Syk-Card9-dependent activation of human granulocytes
- 2016
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Ingår i: Cellular Microbiology. - : Hindawi Limited. - 1462-5814 .- 1462-5822. ; 18:11, s. 1570-1582
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Tidskriftsartikel (refereegranskat)abstract
- The human restricted pathogen Moraxella catarrhalis is an important causal agent for exacerbations in chronic obstructive lung disease (COPD) in adults. In such patients, increased numbers of granulocytes are present in the airways, which correlate with bacteria-induced exacerbations and severity of the disease. Our study investigated whether the interaction of M. catarrhalis with the human granulocyte-specific carcinoembryonic antigen-related cell adhesion molecule (CEACAM)-3 is linked to NF-κB activation, resulting in chemokine production. Granulocytes from healthy donors and NB4 cells were infected with M. catarrhalis in the presence of different inhibitors, blocking antibodies and siRNA. The supernatants were analysed by ELISA for chemokines. NF-κB activation was determined using a luciferase reporter gene assay and chromatin-immunoprecipitation. We found evidence that the specific engagement of CEACAM3 by Moraxella catarrhalis ubiquitous surface protein A1 (UspA1) results in the activation of pro-inflammatory events, such as degranulation of neutrophils, ROS production and chemokine secretion. The interaction of UspA1 with CEACAM3 induced the activation of the NF-κB pathway via Syk and the Card9 pathway and was dependent on the phosphorylation of the CEACAM3 ITAM -like motif. These findings suggest that the CEACAM3 signalling in neutrophils is able to specifically modulate airway inflammation caused by infection with M. catarrhalis.
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| 46346. |
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| 46347. |
- Heldin, J., et al.
(författare)
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Clinical Remission of Asthma and Allergic Rhinitis- in a Longitudinal Population Study
- 2022
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Ingår i: Journal of Asthma and Allergy. - 1178-6965. ; 15, s. 1569-1578
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although asthma and allergic rhinitis are chronic diseases, some patients experience periods of remission. Information on prognostic factors associated with the remission of asthma and allergic rhinitis is valuable in resource prioritization. This study investigated factors associated with the clinical remission of asthma and allergic rhinitis.Methods: In the Respiratory Health In Northern Europe (RHINE) study, data was collected with questionnaires in stage one (RHINE I, 1989-1992) and two follow-ups (RHINE II, 1999-2001 and RHINE III, 2010-2012) from Sweden, Norway, Denmark, Iceland and Estonia. Clinical remission was defined as having reported asthma or allergic rhinitis in RHINE I or RHINE II but not in RHINE III.Results: Of 13,052 participants, 975 (7.5%) reported asthma in RHINE I or RHINE II, and 3379 (25.9%) allergic rhinitis. Clinical remission of asthma and allergic rhinitis was found in 46.4% and 31.8%, respectively. Living in Estonia (OR (95% CI) 2.44 (1.22- 4.85)) and living in an apartment (1.45 (1.06-1.98)) were related to remission of asthma, while subjects reporting allergic rhinitis (0.68 (0.51-0.90)), asthma onset <= 12 years of age (0.49 (0.35-0.68)), receiving treatment with antibiotics for respiratory illness (0.64 (0.47- 0.87)) were less likely to have asthma remission. Factors related to a higher likelihood of remission of allergic rhinitis were no asthma at baseline, age >= 58 years in RHINE III, allergic rhinitis onset after 12 years of age, living in rural areas as a child, having only a primary school education and not being pregnant.Conclusion: Clinical remission was found in almost one-half of those with asthma and one-third of persons with allergic rhinitis. Coexisting allergic symptoms were associated with less clinical asthma remission. Age, asthma symptoms and environmental factors in childhood, such as living in a rural area, were found to influence the clinical remission of allergic rhinitis.
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| 46348. |
- Helgadóttir, Saga Huld, 1991, et al.
(författare)
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Vitamin C Pretreatment Enhances the Antibacterial Effect of Cold Atmospheric Plasma
- 2017
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Ingår i: Frontiers in cellular and infection microbiology. - : Frontiers Media SA. - 2235-2988. ; 7:FEB
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Tidskriftsartikel (refereegranskat)abstract
- Bacterial biofilms are three-dimensional structures containing bacterial cells enveloped in a protective polymeric matrix, which renders them highly resistant to antibiotics and the human immune system. Therefore, the capacity to make biofilms is considered as a major virulence factor for pathogenic bacteria. Cold Atmospheric Plasma (CAP) is known to be quite efficient in eradicating planktonic bacteria, but its effectiveness against biofilms has not been thoroughly investigated. The goal of this study was to evaluate the effect of exposure of CAP against mature biofilm for different time intervals and to evaluate the effect of combined treatment with vitamin C. We demonstrate that CAP is not very effective against 48 h mature bacterial biofilms of several common opportunistic pathogens: Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa. However, if bacterial biofilms are pre-treated with vitamin C for 15 min before exposure to CAP, a significantly stronger bactericidal effect can be obtained. Vitamin C pretreatment enhances the bactericidal effect of cold plasma by reducing the viability from 10 to 2% in E. coli biofilm, 50 to 11% in P. aeruginosa, and 61 to 18% in S. epidermidis biofilm. Since it is not feasible to use extended CAP treatments in medical practice, we argue that the pre-treatment of infectious lesions with vitamin C prior to CAP exposure can be a viable route for efficient eradication of bacterial biofilms in many different applications.
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| 46349. |
- Helgeby, Anja, 1967
(författare)
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The development of a new combined adjuvant vector for mucosal immunization CTA1-DD/ISCOM
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The CTA1-DD/ISCOMs vector is a rationally designed mucosal adjuvant that was developed to host the distinctive properties of either adjuvant alone or in a combination that hosted additive enhancing effects on mucosal immune responses. Here I demonstrate that CTA1-DD can be incorporated into the ISCOM with greatly augmented immunogenicity of both incorporated and admixed antigen. The combined vector was a highly effective enhancer of a broad range of immune responses including specific antibodies and CD4+ T cell immunity. In particular, mucosal specific IgA responses in the respiratory and the genital tracts were strongly augmented by the combined vector, a mechanism that was enzyme dependent since the presence of the enzymatically inactive CTA1R7K-DD component failed to enhance the response above that with ISCOMs alone. Antigen incorporated into the combined vector could be presented by B cells as well as dendritic cells (DC). I also found that B cells in the lymph node were indeed targeted by the combined vector, but not by ISCOMs alone. The CTA1-DD/ISCOMs vaccine vector combines properties from two distinctive adjuvant systems. The ISCOM targets DC while the CTA1-exerts ADP-ribosylating functions. Following subcutaneous injection the CTA1-DD/ISCOMs vector induced a substantial increase in the cellularity of the draining lymph node, which was particularly evident for B cells and even more for granulocytes. These effects were enzyme-dependent as the inactive mutant CTA1R7K-DD/ISCOMs did not elicit a similar pattern. Functional studies of highly enriched DC in vitro demonstrated that the combined vector was superior at stimulating pro-inflammatory cytokines and chemokines, notably IL-1β, MIP-1 and RANTES, compared with ISCOMs alone. These effects appeared not to be due to better binding/up-take of the combined vector in DC, rather they depended on an intact enzymatic activity of the CTA1-enzyme. These findings help explain which are the critical properties added by the CTA1-DD to the ISCOM adjuvant. In my final article I used an adoptive transfer system to investigate the specific induction of genital tract CD4+ T cells by using ovalbumin (OVA) as our model antigen. Transfer of OVA specific T cell receptor (TCR) transgenic CD4+ T cells to naïve normal mice allows for tracking these cells using a TCR-specific antibody, KJ.126, after immunizations with or without adjuvant vectors. I found that hormones play an important role in the priming of T cells, since estrogen-treated mice failed to respond and progesterone-treated mice greatly expanded their OVA-specific T cells following immunization. Progesterone treatment expanded the OVA-specific T cells in a dose dependent way in regional lymph nodes. I also investigated the role of local verses systemic immunization on activation of genital tract T cells and found that both vaginal and intranasal immunizations with cholera toxin conjugated to OVA (CT-OVA) strongly expanded KJ.126+ T cells in the draining lymph node (Para aortic lymph node). However, local immunization was significantly more effective and was also an absolute requirement to attract T cells to the genital tract mucosa. These results convincingly demonstrate that not only antibody responses, but also antigen-specific T cell responses are effectively primed and boosted by local genital tract immunizations.
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| 46350. |
- Helin, I, et al.
(författare)
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Outbreak of coxsackievirus A-14 meningitis among newborns in a maternity hospital ward
- 1987
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 76:2, s. 234-238
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Tidskriftsartikel (refereegranskat)abstract
- During the late winter of 1983, 16 newborns with vague symptoms of failure to thrive, reluctance to feed and a slight rise in body temperature, were found to have meningitis caused by Coxsackievirus A-14. The cerebrospinal fluid showed pleocytosis with polymorphonuclear cells in excess but was otherwise normal. The clinical course was uneventful in all infants, but two of them demonstrated clinical signs of incipient cerebral oedema during the acute phase of the illness. An electroencephalogram (EEG) during the initial course of the disease and at nine months of age was normal in all. During a follow-up period of 2 1/2 years they all developed normally and no sequelae were noted. The presentation also demonstrates the usefulness of Vero cells for the propagation of the responsible virus.
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