scholarly journals Early Prognosis Effect of Cellular Immune Paralysis on Brain Complications of Extracorporeal Membrane Oxygenation Children with Severe Sepsis

2021 ◽  
pp. 1-15
Author(s):  
Yan Xing ◽  
Dongliang Cheng ◽  
Changsong Shi ◽  
Zhiqing Shen
Keyword(s):  
Immune Response ◽  
Severe Sepsis ◽  
Extracorporeal Membrane Oxygenation ◽  
Adaptive Immune Response ◽  
Group Iii ◽  
Adaptive Immune ◽  
Brain Complications ◽  
Group I ◽  
Group Ii ◽  
The Relationship

<b><i>Objective:</i></b> The aim of the study was to explore the relationship between criticality, brain complications, and immune mechanisms in extracorporeal membrane oxygenation (ECMO) children with pneumonia and severe sepsis. <b><i>Methods:</i></b> Patients with simple pneumonia (group I), ECMO patients with pneumonia and severe sepsis accompanied by brain complications (group II), and those without brain complication (group III) admitted to our pediatric intensive care unit were selected to be investigated. The relationship among the peripheral blood subgroups of immune cells, immune factors, adaptive immune responses, endothelial factors, and criticality and brain complications was then studied. <b><i>Results:</i></b> Severe paralysis of normal immunity, excess abnormal immunity, and endothelial injury were consistent with the increase in the absolute value of base excess, lactic acid (Lac) content, and average hospitalization days and brain complications involved in group II (vs. group I). The ratio of CD63<sup>+</sup> macrophage and CD63<sup>+</sup> neutrophil subpopulation increased (<i>p</i> &#x3c; 0.05); the expression levels of elastase<sup>+</sup> neutrophil denatured subgroup (<i>p</i> &#x3c; 0.05), the ratio of CCR2<sup>high</sup>CX3CR1<sup>low</sup>/CCR2<sup>low</sup>CX3CR1<sup>high</sup> of macrophages and neutrophils (<i>p</i> &#x3c; 0.0001), high-mobility group box 1 (HMGB1), YTHDF1, interleukin-17 protein and mRNA, and RAGE gene decreased to some extent (<i>p</i> &#x3c; 0.05); the expression levels of Th1 cells chemokine CXCL9 protein and mRNA and sTIE2 protein increased to some extent (<i>p</i> &#x3c; 0.05); the adaptive immune response of CD8<sup>+</sup> CTL stimulated by lipopolysaccharide (LPS) was slightly enhanced (<i>p</i> &#x3c; 0.05) in group III(vs. group II), which was consistent with the improvement of criticality, average hospitalization days, and the absence of brain complications in group III (vs. group II). <b><i>Conclusion:</i></b> ECMO support with brain complication was related to the upregulation of HMGB1 and YTHDF1 protein; the decreased number of CD63<sup>+</sup> macrophages and neutrophils; the increased denatured neutrophil subgroup, especially the upregulated ratio of CCR2<sup>high</sup>CX3CR1<sup>low</sup>/CCR2<sup>low</sup>CX3CR1<sup>high</sup> of macrophages and neutrophils; the imbalance of Th17/Th1, LPS-specific CD8<sup>+</sup> CTL adaptive immune response paralysis; and the reduced endothelial sTIE2 protein expression level which caused clinical deterioration and prolonged average hospitalization days.

scholarly journals The Relationship Between Dental Caries and YKL-40 Levels in Saliva

2020 ◽  
Author(s):  
Gülsüm Duruk ◽  
Esra Laloglu
Keyword(s):  
Dental Caries ◽  
Group Iii ◽  
Group I ◽  
Pufa Index ◽  
Icdas Ii ◽  
Significant Difference ◽  
Group Ii ◽  
And Gender ◽  
Post Hoc ◽  
The Relationship

Abstract Objective : YKL-40, a new biomarker of localized inflammation, is secreted by macrophages and regulates inflammation and immune responses. The aim of this study was to investigate YKL-40 levels in saliva and compare the level of this mediator in healthy and unhealthy oral cavity. Methods: 85 children (46 girls, 39 boys), aged 6-15 (mean±SD: 9.15±2.16) were included in this study. The children were divided into three groups: Group-I (control, n=25, DMFT/dmft=0), Group-II (n=30, exist of localized dental caries) and Group-III (n=30, exist of localized advanced dental caries). Gingival index (GI), plaque index (PI), DMFT/dmft, DMFS/dmfs, and the number of advanced dental caries according to the ICDAS II and PUFA/pufa index were recorded. Saliva was collected and YKL-40 concentrations were measured. One-way ANOVA with Tukey post hoc, Kruskal-Wallis, multiple regression analysis, and Sperman’s correlation tests were used for statistical analysis. Results: The highest level of YKL-40 was obtained in group III , followed by groups II and I , respectively (p<0.01). In Group II, DMFT/dmft scores and the number of caries (DT/dt) were higher than in group III (p<0.01). In group III, there was a statistically significant correlation between YKL-40 levels in saliva and the number of advanced dental caries. In addition, there was no statistically significant difference in terms of age and gender (p>0.05). Conclusion: Advanced dental caries, rather than DMFT/dmft score, may play an important role in the increasing levels of YKL-40 in saliva.

scholarly journals Interleukin-1β, interleukin-6 and tumour necrosis factor-alpha levels in blood and saliva in hypothyroidism accompanied with periodontitis

2019 ◽  
Vol 10 (2) ◽  
pp. 1361-1366
Author(s):  
Sahar H. Al-Hindawi ◽  
Batool Hassan Al-Ghurabi
Keyword(s):  
Immune Response ◽  
Periodontal Disease ◽  
Study Groups ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
Group Iii ◽  
Group I ◽  
Salivary Level ◽  
Tnf Α ◽  
Group Ii

Relationship between thyroid dysfunction and periodontal disease has been mediated through an immune response. Cytokines are implicated in the initiation, consequences of immune response and a crucial role in the pathogenesis of thyroid disease, directly target thyroid follicular cells; and in the development and progression of periodontitis. This study aimed to detect cytokines levels which known to be associated with periodontitis in serum and saliva, to test the hypothesis that hypothyroidism influences the levels of biomarkers of periodontitis. Samples were collected from sixty patients with hypothyroid age ranged (20-64) years, thirty of patients were without periodontitis (group I) and 30 with periodontal disease (II); moreover, 30 subjects considered as control (group III) with age (20-53) years. Detection of cytokines was performed by ELISA. The results showed a significant elevation in serum and salivary levels of IL-1β (P<0.001) among patients’ groups (I and II) as compared to group III, as well IL-1β increase significantly in group II (P<0.001) than in group I and also than group III. There are non-significant differences (P>0.05) in serum level of IL-6 and TNF-α and salivary levels of TNF-α among all study groups. Nevertheless, the salivary level of IL-6 is increased significantly (P<0.05) in group II as compared with group I and group III, and their non-significant differences (P<0.05) between groups I and III. The present finding proposed that hypothyroidism might encourage periodontitis development; as well as serum and salivary levels of IL-1β, with salivary IL-6 may represent important biomarkers for the early detection of periodontitis in hypothyroid patients.

scholarly journals Influence of the anterior chamber depth on the accuracy of IOL optical power calculation in short eyes

2021 ◽  
Author(s):  
Кирилл Борисович Першин ◽  
Надежда Федоровна Пашинова ◽  
Иван Александрович Лих ◽  
Александр Юрьевич Цыганков ◽  
Абдусамад Аристанович Ахраров
Keyword(s):  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Optical Power ◽  
Power Calculation ◽  
Group Iii ◽  
Group I ◽  
Retrospective Comparison ◽  
Group Ii ◽  
The Relationship

Aim. Determination of the relationship between the anterior chamber depth and the and accuracy of the IOL optical power calculating in the eyes with an axial length of less than 22 mm. Materials and methods. A total of 86 patients (133 eyes) with a short axis (from 18.54 to 21.98 (20.7 0.9) mm) were included in the study. Group I (n=40) consisted of patients with an ACD of less than 2, 5 mm. Group II (n=49) included patients with ACD from 2.5 to 2.9 mm Group III (n=44) included patients with ACD greater than 2.9 mm The calculation of the IOL optical power was carried out according to the formula SRK / T, retrospective comparison - according to the formulas Hoffer-Q, Holladay II, Olsen, Haigis and Barrett Universal II. Results. In group I, there were no significant differences when comparing MedAE for the six formulas (p0.05). The highest MedAE values ​​(0.51 and 0.49, respectively) and the smaller MNE range (-0.03 0.89 and -0.01 0.97, respectively) are shown for the formulas Haigis and Barrett Universal II. In group II, the MedAE for the Haigis formula was 0.45, for SRK / T and Olsen it was 0.59 and 0.66. For the Haigis formula, the lowest MNE value (0.05 0.69) is shown. In group III, no significant differences were found when comparing the average values ​​of MedAE (0.05). The lowest MedAE (0.17) and the best MNE values ​​(-0.01 0.58) are shown for the Haigis formula, while the SRK / T formula was characterized by the highest MedAE (0.37). In group II, the refractive index 0.25 and 0.50 D for the Haigis formula was significantly higher. Conclusion. For eyes with an ACD of less than 2.4 mm, none of the formulas showed a significant advantage, while with an ACD of 2.4-2.9 mm and higher, the use of the Haigis formula is recommended, and the SRK / T formula showed the worst result. The data obtained dictate the need to review existing standards for calculating the IOL optical power in patients with short eyes depending on ACD.

Evaluation of the Immunomodulatory Effects of Thymus vulgaris Ethanolic Leaf Extract Combination with Partially Purified Lipopolysaccharide from Proteus mirabilis in Mice

2019 ◽  
Vol 10 (04) ◽  
pp. 625-630
Author(s):  
Ali M Al-Dahbi ◽  
Ihsan Dhari Awad
Keyword(s):  
Immune Response ◽  
Humoral Immune Response ◽  
Phagocytic Activity ◽  
Ethanolic Extract ◽  
Group Iv ◽  
Thymus Vulgaris ◽  
Group Iii ◽  
Humoral Immune ◽  
Group I ◽  
Group Ii

The current study was carried out to study a high injection dose of the ethanolic extract thymus vulgaris leaf (500 ug /Kg) against the immune response combination with partially purified extracted Lipopolysaccharide ( LPS) from Proteus mirablis.Study groups were included four groups; Group I :treated with normal saline. Group II : treated with LPS antigen, Group III: injected subcutaneously ((500 ug /Kg) from ethanolic extract thymus vulgaris, group IV : injected subcutaneously (500 ug /Kg) from ethanolic extract thymus vulgaris leaf and LPS antigen, the immunological assays were measured through the phagocytic activity as (non specific immunity) after day 8 by using the phagocytic activity index.After day I4 the lymphocyte proliferations was estimated by MTT index. For delayed-type hypersensitivity reaction,the result was measured at 24, 48 and 72 hours after LPS antigens injection.While for Humoral immune response, after day 21 and day 28 the antibody production was estimated by indirect immunoflourescent and by Gel electrophoreses.The results were showed no significant difference in the NBT index between Groups but noticed Group III had a value lower than Group II, While the MTT results were revealed, Group IV had the highest value. In the other side of the study the DTH results showed Group IV had the highest value after 48 hr with significant differences (P≤0.05), in addition, the humoral immune response results were consisted gel electrophoresis and indirect immunoflourescent results showed after day 21 and day 28 Group IV had the highest value. The results was showed the ethanolic extract thymus in a high concentration combination with LPS from P. mirabilis had effects on the immune response particularly Humoral immune response and Cellular immune response but still act as anti inflammatory role as revealed in many previous studies.

scholarly journals Signal-averaged electrocardiogram in chronic Chagas' heart disease

1995 ◽  
Vol 113 (2) ◽  
pp. 851-857 ◽  
Author(s):  
Aguinaldo Pereira de Moraes ◽  
Paulo Jorge Moffa ◽  
Eduardo A. Sosa ◽  
Giovanni M. V. Bellotti ◽  
Carlos A. Pastore ◽  
...  
Keyword(s):  
Heart Disease ◽  
Time Domain Analysis ◽  
Group Iv ◽  
Root Mean Square Amplitude ◽  
Group Iii ◽  
Group I ◽  
Chagas Heart Disease ◽  
Group Ii ◽  
The Relationship

The aim of the study was to register the prevalence of late potentials (LP) in patients with chronic Chagas' heart disease (CCD) and the relationship with sustained ventricular tachycardia (SVT). 192 patients (96 males), mean age 42.9 years, with CCD were studied through a Signal Averaged ECG using time domain analysis. According to presence or absence of bundle branch block (BBB) and SVT, four groups of patients were created: Group I (n = 72): without SVT (VT-) and without BBB (BBB-): Group II (n = 27): with SVT (VT+) and BBB-; Group III (n = 63): VT- and with BBB (BBB+); and Group IV (N = 30): VT+ and BBB+. The LP was admitted, with 40 Hz filter, in the groups without BBB using standard criteria of the method. In the group with BBB, the root-mean-square amplitude of the last 40 ms (RMS) < =14µV was considered as an indicator of LP. RESULTS: In groups I and II, LP was present in 21 (78%) of the patients with SVT and in 22 (31%) of the patients without SVT (p < 0.001), with Sensitivity (S) 78%; Specificity (SP) 70% and Accuracy (Ac) 72%. LP was present in 30 (48%) of the patients without and 20 (67%) of the patients with SVT, in groups III and IV. p = 0.066, with S = 66%; SP = 52%; and Ac = 57%. In the follow-up, there were 4 deaths unrelated to arrhythmic events, all of them did not have LP. Eight (29,6%) of the patients from group II and 4 (13%) from group IV presented recurrence of SVT and 91,6% of these patients had LP. CONCLUSIONS: LP occurred in 77.7% of the patients with SVT and without BBB. In the groups with BBB, there was association of LP with SVT in 66,6% of the cases. The recurrence of SVT was present in 21% of the cases from which 91,6% had LP.

scholarly journals Hospitalized Patients with a Therapeutic Profile: The Relationship Between the Type of Attitude Towards Illness and the Quality of Life

2020 ◽  
Vol 9 (4) ◽  
pp. 36-56
Author(s):  
N.V. Zarishnyak ◽  
A.M. Kulbaisov ◽  
E.V. Gavrilova
Keyword(s):  
Quality Of Life ◽  
Hospitalized Patients ◽  
High Rate ◽  
Chronic Obstructive ◽  
Disease Group ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
The Relationship

The article presents the results of a study of attitudes towards illness, quality of life and their relationship in hospitalized patients. An empirical study of three groups of hospitalized patients aged 40 to 80 years was carried out: with ischemic heart disease (group I, n = 22; 55,3(13,8) years), with chronic obstructive pulmonary disease (group II, n=22; 53,7(12,0) years) and with osteochondrosis (group III, n=22; 59,6(14,8) years). Distribution by sex in all groups – 50% of men and 50% of women. To determine the type of attitude towards the disease, the Bekhterev Institute's questionnaire "Type of attitude towards the disease" (TOBOL) was used, the quality of life – the questionnaire of the Assessment of the quality of life (SF-36). The results of the study showed that in patients of all groups maladaptive types of attitudes towards the disease prevailed: Group I – hypochondriacal; apathetic; Group II – neurasthenic, dysphoric, paranoid; Group III – anxious, apathetic types. The quality of life of patients of all groups did not differ from each other: the physical component of health was assessed as low; the psychological component of health was average. A high rate of pain syndrome and social functioning was found in patients in group I, and in general health in patients in group II. Factor analysis revealed the relationship between the general state of health of patients (the patient's subjective assessment of his health) and the type of attitude towards the disease. Most of the patients needed psychological help to correct the type of attitude towards the disease and improve the quality of life. The revealed relationship between the internal picture of the disease and the quality of life requires additional research.

scholarly journals The Relationship Between Dental Caries and YKL-40 Levels in Saliva

2019 ◽  
Author(s):  
Gülsüm Duruk ◽  
Esra Laloglu
Keyword(s):  
Dental Caries ◽  
Group Iii ◽  
Group I ◽  
Pufa Index ◽  
Icdas Ii ◽  
Significant Difference ◽  
Group Ii ◽  
And Gender ◽  
Post Hoc ◽  
The Relationship

Abstract Objective: YKL-40, a new biomarker of localized inflammation, is secreted by macrophages and regulates inflammation and immune responses. The aim of this study was to investigate YKL-40 levels in saliva and compare the level of this mediator in oral cavity. Methods: 85 children (46 girls, 39 boys), aged 6-15 (mean±SD: 9.15±2.16) were included in this study. The children were divided into three groups: Group-I (control, n=25, DMFT/dmft=0), Group-II (n=30, exist of localized dental caries) and Group-III (n=30, exist of localized advanced dental caries). Gingival index (GI), plaque index (PI), DMFT/dmft, DMFS/dmfs, and the number of advanced dental caries according to the ICDAS II and PUFA/pufa index were recorded. Saliva was collected and YKL-40 concentrations were measured. One-way ANOVA withTukey post hoc, Kruskal-Wallis, multiple regression analysis, and Sperman’s correlation tests were used for statistical analysis. Results: The highest level of YKL-40 was obtained in group III, followed by groups II and I, respectively (p<0.01). In Group II, DMFT/dmft scores and the number of caries (DT/dt) were higher than in group III (p<0.01). In group III, there was a statistically significant correlation between YKL-40 levels in saliva and the number of advanced dental caries. In addition, there was no statistically significant difference in terms of age and gender (p>0.05). Conclusion: Advanced dental caries, rather than DMFT/dmft score, may play an important role in the increasing levels of YKL-40 in saliva.

scholarly journals High Fibrinogen Level is An Independent Predictor of Presence and Severity of Coronary Artery Disease

2014 ◽  
Vol 7 (1) ◽  
pp. 4-10 ◽  
Author(s):  
M Ahmed ◽  
NA Chowdhury ◽  
G Sofdar ◽  
SK Chakrovortty ◽  
M Rahman ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Fibrinogen Level ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Artery Disease ◽  
Vessel Score ◽  
The Relationship

Background: Fibrinogen has been identified as an independent risk factor for cardiovascular disease and associated with traditional cardiovascular risk factors. Few reports have so far investigated the relationship between fibrinogen levels and the extent of coronary artery disease (CAD) as evaluated by coronary angiography. Therefore the current study was carried out to evaluate the relationship between fibrinogen levels and the extent of CAD as evidenced by coronary angiography. Method: A total of 210 patients having ischemic heart disease including chronic stable angina, unstable angina, non-ST elevated myocardial infarction & ST elevated myocardial infarction were evaluated in National Institute of Cardiovascular Disease (NICVD), Dhaka with a view to find out the relationship between fibrinogen levels and the extent of CAD undergoing coronary angiography. Patients were divided in 3 groups according to fibrinogen levels: Group I = fibrinogen levels <400 mg/dl, Group II = fibrinogen levels (400-600) mg/dl, Group III = fibrinogen levels > 600 mg/dl. In this study, angiographic severity was assessed by vessel score, stenosis score and lesion morphology and tries to find out their relationship with angiographic severity and fibrinogen level. Result: Using a prospective analytic design we studied 210 patients who were divided into 3 groups : Vessel score in Group I, Group II & Group III were 1.14 ± 0.56, 2.24 ± 0.58, & 3.00 ± 0.65 respectively which was statistically significant (p < 0.01) and Stenosis score in group- I, group- II & group- III were 6.00 ± 4.19, 18.72 ± 4.94, & 32.41 ± 15.75 respectively which was statistically significant (p < 0.01). Regarding morphology of the lesions, complex lesions in group I, group II & group III were 21%, 32% & 39% respectively (statistically significant; p < 0.01). Conclusion: High fibrinogen level is independently and significantly associated with more severe coronary artery disease. Serum fibrinogen can be used as a new and even simpler tool for risk stratification in acute coronary syndrome. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20784 Cardiovasc. j. 2014; 7(1): 4-10

Association between secondhand smoke exposure and new-onset hypertension in 65169 self-reported never smokers verified by cotinine

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B.J Kim ◽  
D.C Seo ◽  
B.S Kim
Keyword(s):  
Group Iv ◽  
Exposure Group ◽  
Group Iii ◽  
Group I ◽  
Shs Exposure ◽  
Group Ii ◽  
Never Smokers ◽  
The Relationship ◽  
New Onset

Abstract Background No study has reported the relationship between secondhand smoke (SHS) exposure and new-onset hypertension (NOHT) in self-reported never-smokers verified by cotinine. Purpose This longitudinal study was conducted to evaluate whether the change of SHS exposure status at baseline and at follow-up affects NOHT in self-reported and cotinine-verified never-smokers. Methods Out of individuals enrolled in the Kangbuk Samsung Cohort study (KSCS) between 2012 and 2016, 65,169 self-reported and cotinine-verified never-smokers without hypertension at baseline visit (20,046 men; age 36±5.7 years) were included. The mean follow-up period in this study was 32 months (6–58 months). SHS exposure was defined as having experienced passive smoking indoors at home or the workplace. Individuals were divided into 4 groups on the basis of their SHS exposure status at baseline and at follow-up: no SHS exposure group (Group I) as individuals without SHS exposure both at baseline and at follow-up; new SHS exposure group (Group II) as those without SHS exposure at baseline and with SHS exposure at follow-up; ex-SHS exposure group (Group III) as those with SHS exposure at baseline and without SHS exposure at follow-up; continuous SHS exposure group (Group IV) as those with SHS exposure both at baseline and at follow-up. New-onset hypertension was defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, or current use of antihypertensive medication(s) at follow-up. Results The incidence of NOHT in the overall population was 2.5%; the incidence in group I, II, III, and IV was 2.3%, 3.2%, 2.9%, and 3.1%, respectively (p&lt;0.001). The results in a multivariate Cox-hazard model adjusted for the baseline variables including age, sex, body mass index, waist circumference, vigorous exercise, alcohol consumption and presence of diabetes showed that Group II and IV increased relative risks (RRs) for NOHT compared to Group I (RR[95% CI], 1.44 [1.17, 1.77] for Group II and 1.21 [1.01, 1.45] for Group IV) However, Group III did not increase the risk of NOHT (0.95 [0.83, 1.08]). In another model adjusted for the variables in the above model and creatinine, uric acid, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and high-sensitivity C reactive protein showed that only Group II increased the risk for NOHT (1.43 [1.16, 1.77] in Group II, 0.94 [0.82, 1.07] in Group III, 1.18 [0.98, 1.41] in Group IV). Conclusions This study showed that the new and continuous SHS exposure, but not ex-SHS exposure, increased the risk for NOHT in self-reported never-smokers verified as nonsmokers by urinary cotinine. In particular, the relationship to increased risk for NOHT was more obvious in individuals with new SHS exposure than in those with continuous SHS exposure. These findings suggest that it is important to continuously minimize SHS exposure and prohibit smoking at home and at workplace to reduce the risk of developing hypertension. Funding Acknowledgement Type of funding source: None

scholarly journals CD28 Family and Chronic Rejection: “To Belatacept...and Beyond!”

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Marcos V. Silva ◽  
Juliana R. Machado ◽  
Laura P. Rocha ◽  
Lúcio R. Castellano ◽  
Marlene A. Reis ◽  
...  
Keyword(s):  
Immune Response ◽  
Chronic Rejection ◽  
Immunosuppressive Agents ◽  
Adaptive Immune Response ◽  
Lymphocyte Activation ◽  
Immunological Response ◽  
Adaptive Immune ◽  
Activation Mechanisms ◽  
And Function ◽  
The Relationship

Kidneys are one of the most frequently transplanted human organs. Immunosuppressive agents may prevent or reverse most acute rejection episodes; however, the graft may still succumb to chronic rejection. The immunological response involved in the chronic rejection process depends on both innate and adaptive immune response. T lymphocytes have a pivotal role in chronic rejection in adaptive immune response. Meanwhile, we aim to present a general overview on the state-of-the-art knowledge of the strategies used for manipulating the lymphocyte activation mechanisms involved in allografts, with emphasis on T-lymphocyte costimulatory and coinhibitory molecules of the B7-CD28 superfamily. A deeper understanding of the structure and function of these molecules improves both the knowledge of the immune system itself and their potential action as rejection inducers or tolerance promoters. In this context, the central role played by CD28 family, especially the relationship between CD28 and CTLA-4, becomes an interesting target for the development of immune-based therapies aiming to increase the survival rate of allografts and to decrease autoimmune phenomena. Good results obtained by the recent development of abatacept and belatacept with potential clinical use aroused better expectations concerning the outcome of transplanted patients.

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