Influence of Rejection Therapy on Fungal and Nocardial Infections in Renal-Transplant Recipients

Bach, MichaelC; Sahyoun, Anthony I.; Adler, JonathanL; Schlesinger, RobertM; Breman, Joel G.; Madras, Peter N.; P’eng, Fang-Ku; Monaco, A

doi:10.1016/s0140-6736(73)90007-x

Cited by 168 publications

(43 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, granulocyte migration and chemotaxis was not effected by HCS concentrations as high as 500 /Lg/ml as previously reported (26). Granulocyte bactericidal activity, however, was impaired by low doses of HCS in the present study, while Mandell, Rubin, and Hook (27) showed consistent impairment only at high concentrations (1,200 /%g/ml) of HCS. The explanation for this lack of agreement of the effect of HCS on granulocyte bactericidal activity is unclear although a number of differences exist in the methodology utilized in these studies.…”

Section: Discussionsupporting

confidence: 78%

Effects of Corticosteroids on Human Monocyte Function

Rinehart¹,

Balcerzak²,

Sagone³

et al. 1974

J. Clin. Invest.

241

View full text Add to dashboard Cite

A B S T R A C T This report examined the effect of corticosteroids in vitro on human peripheral blood monocytes, essential cells in both immune and nonimmune cellular defense mechanisms. Monocyte chemotaxis in response to sera, Escherichia coli filtrate, and lymphokine chemotactic factor was markedly reduced (P < 0.01) by hydrocortisone succinate (HCS) at 16 Ag/ml. Methylprednisolone succinate and unesterified hydrocortisone produced similar impairment of monocyte chemotaxis while two drugs which unmodified do not enter cells, hydrocortisone phosphate (HCP) and cortisone acetate, had no effect on chemotaxis. HCS also significantly impaired monocyte random migration at 16 jug/ml. Monocyte bactericidal activity was reduced by HCS at 16 Ag/ml (P < 0.01) ) but was not affected by HCP even at 120 Lg/ml. In comparison, HCS did not alter granulocyte chemotaxis even at 500 Ag/ml, and bactericidal activity was reduced at 16 jg/ml (P < 0.01). Monocyte phagocytosis of cryptococci was reduced only 20% (P < 0.05) at 120 Ag/ml. HCS at 120 Ag/ml did not alter monocyte base-line or postphagocytic hexosemonophosphate shunt activity, viability by trypan blue exclusion, adherence to tissue culture flasks, or surface binding of IgG globulin. These corticosteroid-induced defects in monocyte function may contribute to reduced cellular defense during corticosteroid therapy.

show abstract

Section: Discussionsupporting

confidence: 78%

Effects of Corticosteroids on Human Monocyte Function

Rinehart¹,

Balcerzak²,

Sagone³

et al. 1974

J. Clin. Invest.

241

View full text Add to dashboard Cite

show abstract

“…Specific risk factors that have been identified for the development of. iocardiosis in renal transplant patients include multiple early rejection episodes (more than two in the first 2 months), intensive immunosuppressive therapy (high-dose prednisolone and azathioprine), age (< 10 and >40 years), type of graft (unrelated versus living related donor kidney), presence of granulocytopenia, and uremia resulting from impaired allograft function (6,27,170,565). A recent development that may tend to reduce the number of nocardial infections that occur in this population is the substitution of cyclosporine for high-dose prednisolone and azathioprine in antirejection regimens.…”

Section: Epidemiologic Aspects Of Infection In Humansmentioning

confidence: 99%

The medically important aerobic actinomycetes: epidemiology and microbiology

1994

View full text Add to dashboard Cite

The aerobic actinomycetes are soil-inhabiting microorganisms that occur worldwide. In 1888, Nocard first recognized the pathogenic potential of this group of microorganisms. Since then, several aerobic actinomycetes have been a major source of interest for the commercial drug industry and have proved to be extremely useful microorganisms for producing novel antimicrobial agents. They have also been well known as potential veterinary pathogens affecting many different animal species. The medically important aerobic actinomycetes may cause significant morbidity and mortality, in particular in highly susceptible severely immunocompromised patients, including transplant recipients and patients infected with human immunodeficiency virus. However, the diagnosis of these infections may be difficult, and effective antimicrobial therapy may be complicated by antimicrobial resistance. The taxonomy of these microorganisms has been problematic. In recent revisions of their classification, new pathogenic species have been recognized. The development of additional and more reliable diagnostic tests and of a standardized method for antimicrobial susceptibility testing and the application of molecular techniques for the diagnosis and subtyping of these microorganisms are needed to better diagnose and treat infected patients and to identify effective control measures for these unusual pathogens. We review the epidemiology and microbiology of the major medically important aerobic actinomycetes.

show abstract

“…Thus, cortisone can break down natural resistance on its own. Myelosuppression rendered mice susceptible only when the first line of defense was overpowered by high chal-INTRODUCTION Invasive aspergillosis, due mainly to Aspergillus fumigatus (AF)1, is a serious problem in immunocompromised patients, especially those with hematologic neoplasia, renal transplants, and chronic granulomatous disease (1)(2)(3)(4)(5). The respiratory tract is generally regarded as the portal of entry for invasive aspergillosis because the lung is frequently infected (1,2), the disease is prevented by filtration of the air in the environment of patients at risk (6), and the spores are small the two major risk factors for invasive aspergillosis (1,2) and that the combination may act synergistically to break down natural resistance (2).…”

mentioning

confidence: 99%

Selective Protection against Conidia by Mononuclear and against Mycelia by Polymorphonuclear Phagocytes in Resistance to Aspergillus

Schaffner¹,

Douglas²,

Braude³

1982

J. Clin. Invest.

581

411

View full text Add to dashboard Cite

A B S T R A C T By comparing natural immunity to Aspergillus fumigatus (AF) in vivo with the action of human or mouse phagocytes against AF in vitro, we delineated two sequential lines of defense against AF. The first line of defense was formed by macrophages and directed against spores. Macrophages prevented germination and killed spores in vitro and rapidly eradicated conidia in vivo, even in neutropenic and athymic mice. The second was the neutrophilic granulocyte (PMN), which protected against the hyphal form of AF. Human and mouse PMN killed mycelia in vitro. Normal, but not neutropenic mice, stopped hyphal growth, and eradicated mycelia. Either line of defense acting alone protected mice from high challenge doses. Natural immunity collapsed only when both the reticuloendothelial system and PMN were impaired. These findings are in keeping with the clinical observation that high doses of cortisone and neutropenia are the main risk factors for invasive aspergillosis. Cortisone inhibited the conidiacidal activity of mouse macrophages in vivo and of human or mouse mononuclear phagocytes in vitro. Cortisone damaged this first line of defense directly and not through the influence of T lymphocytes or other systems modifying macrophage function as shown in athymic mice and in vitro. In addition, daily high doses of cortisone in mice reduced the mobilization of PMN so that the second line of defense was also impaired. Thus, cortisone can break down natural resistance on its own. Myelosuppression rendered mice susceptible only when the first line of defense was overpowered by high chal-

show abstract

Influence of Rejection Therapy on Fungal and Nocardial Infections in Renal-Transplant Recipients

Cited by 168 publications

References 24 publications

Effects of Corticosteroids on Human Monocyte Function

Effects of Corticosteroids on Human Monocyte Function

The medically important aerobic actinomycetes: epidemiology and microbiology

Selective Protection against Conidia by Mononuclear and against Mycelia by Polymorphonuclear Phagocytes in Resistance to Aspergillus

Contact Info

Product

Resources

About