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Immunology --- Immunology. --- Immune System Diseases. --- Immune System Phenomena. --- Microbiology & Immunology
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Immunology --- Immune System Diseases. --- Immune System Phenomena. --- Microbiology & Immunology
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Infection --- Immune system --- immunology --- Infection --- Immune system --- immunology
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Body: Long-term immunosuppressive therapy (IS) is required for most pediatric liver transplant (LT) recipients. As defined by Calne, prope (almost) tolerance may constitute an optimal condition combining grafi acceptance with very low IS load and minimal IS-related toxicity. It’s interesting to try to understand what promotes the prope tolerance status. Methods: We reviewed 171 pediatric (median age at LT: 3.6 years; range : 0.17-16.6years) long-term survivors after LT, transplanted between 04/1999 and 06/2007 under tacrolimus-based regimens (deceased donors n=97. 57 %; living donors : n=74. 43 %), with a median follow-up post-LT of 5.0 years (range : 0.9-9.5 years). Their current status regarding IS therapy was analysed and correlated with the initial IS immunoprophylaxis. Prope tolerance was defined as tacrolimus monotherapy, with mean trough blood levels <4ng/ml during the preceding year of follow-up, combined with normal liver function tests. Results: The 66 children transplanted before 04/2001 received a standard tacrolimus-steroids regimen. Beyond 04/2001, the subsequent 105 patients received steroid-free tacrolimus-basiliximab or -daclizumab immunoprophylaxis. In the latter group, 43 (41 %) never experienced any acute rejection episode and, consequently, never received steroids. In the long term, a total of 79 recipients (47 %) developed prope tolerance (n=73) or IS-free operational tolerance (n=6), 27 of them belonging to the 43 steroid-free patients (63 %). In contrast, only 52/128 (41 %) children treated with steroids subsequently developed prope/operational tolerance. Correlation between initial immunoprophylaxis and current IS therapy showed that prope/operational tolerance was significantly associated with steroid avoidance during the whole transplant follow-up (p=O.Ol2). Conclusion: Steroid-free tacrolimus-based IS seems to promote long term graft acceptance under minimal/no IS. If confirmed, these results constitute the first evidence that minimization of IS, including steroid avoidance, might be tolerogenic in the long term after pediatric LT Introduction: Le traitement immunosuppresseur (IS) à long terme est requis pour la majorité des enfants ayant subi une transplantation hépatique (TH). Comme défini par Came, la prope (ou “quasi”) tolérance constitue un statut où l’acceptation du greffon est optimale sous une immunosuppression minimale et avec une faible toxicité due aux IS. Il est intéressant d’essayer de comprendre ce qui favorise l’évolution vers ce statut de prope tolérance. Patients et Méthodes: La population étudiée est composée de 171 patients (âge médian à la TH: 3.60 ans, range: 0.17-16.60 ans) transplantés entre 04/1999 et 06/2007, sous une immunoprophylaxie basée sur le tacrolimus (donneurs cadavériques n=97, 57%; donneurs vivants : n74, 43%), et dont le follow-up médian post-TH est de 5.00 ans (range: 0.90-9.50 ans). Leurs traitements IS actuels ont été, analysés et comparés aux traitements IS post-greffe immédiat. La prope tolérance est définie comme une monothérapie basée sur le tacrolimus avec un taux sanguin moyen, durant la dernière année de follow-up, inférieur ou égal à 4ng/ml, cet état étant combiné à des tests hépatiques de maximum 2 fois la normale. Résultats: Les 66 enfants transplantés avant 04/2001 ont reçu une immunoprophylaxie standard comprenant du tacrolimus et des corticoïdes. Après 04/2001, les 105 patients restants ont reçu un traitement IS combinant tacrolimus et un anticorps monoclonal anti-IL-2R (basiliximab ou daclizimab), sans corticoïdes. À long terme, 79 receveurs (47%) ont développé un état de prope tolérance (n=73) ou de tolérance opérationnelle çad. sans IS (n=6). Dans le groupe des enfants n’ayant pas eu de corticoïdes dans leur immunoprophylaxie de départ, 43 n’ont jamais présenté d’épisode de rejet aigu et donc, par conséquent, n’ont jamais reçu de corticoïdes. Parmi ces enfants, 63% ont développé un état de prope tolérance ou de tolérance opérationnelle. Par contre, seulement 41% des enfants ayant reçu à un moment de leur évolution des corticoïdes on développé un état de tolérance. La corrélation entre l’immunoprophylaxie initiale et le traitement IS courant montre que le statut de tolérance est significativement associé à un traitement IS sans corticoïdes, et ce durant la totalité du follow-up post-TH (p=0.012). Conclusion: Une IS basée sur le tacrolimus sans corticoïdes semble promouvoir l’acceptation à long terme du greffon sous une IS minimale, voire sans IS. S’ils se confirment, ces résultats constituent la première évidence qu’une minimisation de l’IS, sans corticoïde, permettrait d’atteindre un état de tolérance du greffon à long terme en TH pédiatrique.
Liver Transplantation --- Immune Tolerance --- Infant --- Child --- Tacrolimus
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This Ebook provides an interesting and up-to-date overview of Parasite Immunology in terms of a survival battle between hosts and parasites, describing firstly how parasites interact with different B cell compartments and trigger a vigorous antibody response. An Interesting chapter deals with new insights into immune diagnosis in Trypanosoma cruzi infection, while another chapter on malaria vaccines critically reviews their development since the beginning, examining the basis for failures or successes encountered in clinical trials. Chapters on immunological aspects of amoebiasis, giardiasis,
Protozoa, Pathogenic. --- Medical parasitology. --- Immune response.
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This book explains how the immune system functions, namely, how individual cells of the immune system make the decision to respond or not to respond to foreign microbes and molecules, and how the critical molecules function to trigger the cellular reactions in an all-or-none (quantal) manner. To date, there has not been a complete description of the immune system and its cells and molecules, primarily because most of the information has accumulated only in the last 40 years and our understanding has been expanding rapidly only in the last 20 years. It is now clear that the cells have evolved a
Immune response. --- Interleukin-2. --- T cells.
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immune system --- immune system --- immunity --- immunity --- medical sciences --- medical sciences --- Immunology --- Immunology --- Immunological techniques --- Immunological techniques --- Immunological diseases --- Immunological diseases --- Human pathology --- Human pathology --- Immune response --- Immune response
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Allergy and immunology --- Immune system --- Immune system diseases --- Immunity --- Immunologic techniques --- history --- Allergy and immunology --- Immune system --- Immune system diseases --- Immunity --- Immunologic techniques --- history
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In recent years, the critical role of microRNAs has been revealed within the biology of cells that constitute the immune system. In MicroRNAs and the Immune System: Methods and Protocols, expert researchers explore the latest techniques for studying miRNA expression, including the most up-to-date data on splinted ligation and qRT-PCR assays, as well as high-throughput profiling through cloning, deep sequencing, and microarrays. Chapters outline methods to study miRNA functions in various cell types from a single cell type level to entire model organisms, and present studies of miRNAs in the context of viruses and the immune response. Tools are also provided to help navigate bioinformatics databases on miRNAs and their targets. Composed in the highly successful Methods in Molecular Biology™ series format, each chapter contains a brief introduction, step-by-step methods, a list of necessary materials, and a Notes section which shares tips on troubleshooting and avoiding known pitfalls. Contemporary and innovative, MicroRNAs and the Immune System: Methods and Protocols is an essential handbook for immunologists, biochemists, and molecular biologists.
Immunology. --- Immunobiology --- Life sciences --- Serology --- Small interfering RNA --- Immune system --- Immune system - Physiology - Laboratory manuals
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