The antiphospholipid syndrome and infection

Dalekos, Georgios N.; Zachou, Kalliopi; Liaskos, Christos

doi:10.1007/s11926-001-0031-4

Cited by 51 publications

(49 citation statements)

References 50 publications

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“…Rather, the presence of an elevated anticardiolipin antibody titer may simply reflect the high prevalence in the general ESRD population. The implication that in most ESRD patients, a positive APA represents an epiphenomenon, is comparable to data describing APA in patients with infections in which no convincing association with thrombophilia has been observed (8,9).…”

Section: Discussionsupporting

confidence: 77%

“…It is unclear, however, whether these ACA are thrombogenic, or simply represent an epiphenomenon. For example, APA may frequently be detected in the setting of infection, but most studies have found no association with thrombophilia (8,9). In the dialysis population, the published data does not convincingly link APA with vascular access thrombosis (10,11).…”

Section: Introductionmentioning

confidence: 96%

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Significance of Anticardiolipin Antibodies on Short and Long Term Allograft Survival and Function following Kidney Transplantation

Forman

Lin

Pascual

et al. 2004

American Journal of Transplantation

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The significance of anticardiolipin antibodies (ACAs) prior to renal transplantation is unclear. We studied a cohort of 337 patients who underwent renal transplantation from 1996 to 2001. Follow-up continued until allograft loss, patient death or 31 December 2002. The primary outcome was a composite endpoint of death-censored allograft loss or a 25% reduction in estimated glomerular filtration rate (GFR) from 1-month post-transplant. Secondary outcomes were allograft loss, a 25% reduction in GFR, acute rejection and creatinine at 1 year. IgG and IgM ACA titers were positive (≥15) in 18.1% of recipients. There were no significant differences at baseline between recipients, except coumadin therapy in those with positive ACA titers (20% vs. 7.4%). Post-transplant, there was no increase in the primary outcome in ACA-positive patients, even after adjustment for anticoagulation with coumadin (HR = 1.42 [0.68, 2.96]). There was no difference in secondary outcomes between those with or without positive titers. Two of five patients with very high titers (>50) who were not anticoagulated had early graft loss. A positive ACA titer prior to kidney transplantation was not associated with inferior renal outcomes after transplantation, although more research is required to address the prognostic significance of very high ACA titers.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 96%

Significance of Anticardiolipin Antibodies on Short and Long Term Allograft Survival and Function following Kidney Transplantation

Forman

Lin

Pascual

et al. 2004

American Journal of Transplantation

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“…Some viruses, particularly the HCV, can modulate the systemic immunoregulation beside its local effects [15, 16, 17, 18, 19, 20, 21]. Though several reports were published on TTV [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13], the pathogenic importance of this virus remained still unknown.…”

Section: Discussionmentioning

confidence: 99%

No Effect of Transfusion Transmitted Virus Viremia on the Distribution and Activation of Peripheral Lymphocytes in Hemodialyzed Patients

Fodor

Ladányi²,

Aleksza³

et al. 2002

Nephron

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Aim: We aimed to examine the distribution and activation of peripheral T cells in TTV positive (n = 32) and negative (n = 17) hemodialyzed patients. The control group (n = 20) consisted of healthy blood donors. Method: TTV-DNA was detected by seminested PCR. CD3, CD4, CD8, CD19, CD56, CD3/HLA-DR, CD3/CD69 and the Th1/Th2 ratio of T cells were analyzed by flow cytometry. Circulating IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-13, TNF-α, TGF-β levels were measured by ELISA in the sera. Results: There was no difference between the CD3, CD4, CD8 and CD19 values of HD subjects. In addition, the expression of both activation markers, HLA-DR and CD69, was significantly elevated in the TTV-positive and -negative HD groups compared to the controls, but not showing any difference from each other. The measurements of intracellular cytokines showed the enhanced occurrence of INF-γ + CD4 T cells, and decreased appearance of IL-4 + CD4 lymphocytes in the HD groups without any significant difference between the TTV virus positive and negative patients. In addition, HD also elevated the expression of IL-10 in CD4 and CD8 (Th2) cells. There were only two significant changes in the levels of circulating cytokines: (a) IL-2 increased; (b) IL-13 decreased in both groups of HD patients compared to the controls, independently of TTV positvity or negativity. Conclusions: We assume that transfusion-transmitted virus does not cause any specific change in the distribution and activation of lymphocytes in the peripheral blood of hemodialyzed patients. Hemodialysis itself, however, results in a significant activation of peripheral T cells with the domination of increased production of Th1 type cytokines, IFN-γ, IL-2, in contrast to the decreased synthesis of Th2 type cytokines, IL-4 and IL-13. Furthermore, the increased expression of IL-10 in the CD4 and CD8 cells of HD patients can be the sign of a contraregulatory Th2 activation as an answer on the Th1 effect.

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“…In contrast, the prevalence of HCV infection is estimated to be low in our area (0.34%), even though clusters of higher HCV prevalence were recently identified by our group [6] . Coexistence, of autoimmune liver diseases like primary biliary cirrhosis (PBC) [7] or autoimmune hepatitis (AIH) [8] with HCV or HBV infections could be a problem especially in endemic areas for viral hepatitis [8] , since viruses in general have long been associated in some cases with the induction of autoimmune phenomena up to the development of overt autoimmune diseases [8][9][10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Primary biliary cirrhosis in HBV and HCV patients: Clinical characteristics and outcome

Rigopoulou

Zachou²,

Gatselis³

et al. 2013

WJH

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AIM:To present the characteristics, management and outcome of patients with hepatitis B virus (HBV) or hepatitis C virus (HCV) infections concurrent with primary biliary cirrhosis (PBC). METHODS:Since January 2001 to September 2009, we retrospectively evaluated the medical records of all HBV (n = 1493) and HCV patients (n = 526) who are followed in our center for the presence of concurrent PBC. Seventeen patients identified with concurrent viral hepatitis and PBC (8 HCV and PBC; follow-up: 61 ± 37 mo and 9 HBV and PBC; follow-up: 57 ± 38 mo). PBC diagnosis was established if the patients met at least two of the following criteria: positivity for antimitochondrial antibody, elevated cholestatic enzymes and histological lesions of PBC. RESULTS:HCV or HBV diagnosis preceded that of PBC in most patients by many years. PBC diagnosis was based on the presence of antimitochondrial antibody and elevated cholestatic enzymes in all 17 patients, while one third (5/17; 29.4%) experienced severe pruritus many years before diagnosis. Patients with PBC and HBV were significantly younger at diagnosis of PBC compared to patients with PBC and HCV (56.1 ± 11.2 vs 68.5 ± 10.3, respectively, P < 0.05). At initial clinical and histological assessment the majority of patients were cirrhotics (10/17; 58.8%) with the group of PBC and HCV carrying the highest frequency (87.5% vs 33.3% in PBC and HBV; P < 0.05). The patients with HBV and concomitant PBC seem to have better outcome compared to those with HCV and PBC since none of the 6 non-cirrhotics with HBV and PBC developed cirrhosis during follow-up.CONCLUSION: PBC diagnosis in HBV or HCV patients is very difficult and usually delayed. Therefore, in any case, cholestasis should alert physicians to further search for PBC.

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The antiphospholipid syndrome and infection

Cited by 51 publications

References 50 publications

Significance of Anticardiolipin Antibodies on Short and Long Term Allograft Survival and Function following Kidney Transplantation

Significance of Anticardiolipin Antibodies on Short and Long Term Allograft Survival and Function following Kidney Transplantation

No Effect of Transfusion Transmitted Virus Viremia on the Distribution and Activation of Peripheral Lymphocytes in Hemodialyzed Patients

Primary biliary cirrhosis in HBV and HCV patients: Clinical characteristics and outcome

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