scholarly journals Reiter’s syndrome - disease of young men: Analysis of 312 patients

2014 ◽  
Vol 67 (7-8) ◽  
pp. 222-230 ◽  
Author(s):  
Jaroslav Bojovic ◽  
Natasa Strelic ◽  
Ljiljana Pavlica
Keyword(s):  
Synovial Fluid ◽  
Human Leukocyte Antigen ◽  
Reactive Arthritis ◽  
Mononuclear Cells ◽  
Clinical Manifestations ◽  
Human Leukocyte ◽  
Multisystem Disease ◽  
Peripheral Blood Mononuclear ◽  
Leukocyte Antigen ◽  
Number Of Patients

Introduction. Reiter?s syndrome is reactive arthritis occurring after acute urogenital (urethritis, cervicitis) or enterocolitis infections. The associated ophthalmological and/or mucocutaneous changes are full clinical manifestations of this disease. This paper was aimed at analyzing clinical and radiological characteristics and findings of possible etiological factors and protocol for Reiter?s syndrome therapy. Material and Methods. Of 312 patients included in the study, 279 were men and 33 were women, the ratio between them being 8.5:1. The disease was diagnosed based on clinical evidence of two basic characteristics of Reiter?s syndrome: arthritis preceded by acute urogenital or enteral infection. Results. Urogenital and enterocolitic form of disease was found in 242 (77.5%) and 52 (16.5%) patients, respectively; whereas the initial cause was not discovered in 18 patients (6%). Three or two main signs of Reiter?s syndrome were present in approximately the same number of patients (41.7% and 44.2%), whereas all four signs of disease were present in 14.1% of the patients. Acute or sub-acute form was present in 40.5%, while recurrent and chronic disease was diagnosed in 31% and 28.5% of the patients, respectively. The most frequent clinical manifestation of this disease was on the locomotor system as asymmetrical oligoarthritis localized in lower extremities, present in 69.4% of the patients. Chlamydia trachomatis was found in the synovial fluid in 54% of patients (20/37), ureaplasma or mycoplasma was isolated in the synovial tissue of 73.1% of patients (30/41) and in the peripheral blood mononuclear cells in 93.2% of patients (41/44). Human leukocyte antigen B27 was present in 83.3% of patients. Conclusion. Reiter?s syndrome is a multisystem disease, predominantly occurring in human leukocyte antigen B27 positive young males. The fact that the causative agents are found in the synovial membrane or synovial fluid is indicative of infectious rather than reactive arthritis.

Electrostatic human leukocyte antigen-neoantigen interactions and durable benefit in non-small cell lung cancer patients treated with immunotherapy.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 2635-2635
Author(s):  
Amy Lauren Cummings ◽  
Jaklin Gukasyan ◽  
Henry Lu ◽  
Benji Bachrach ◽  
John Madrigal ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Electrostatic Interactions ◽  
Mononuclear Cells ◽  
Single Agent ◽  
Human Leukocyte ◽  
Feature Binding ◽  
Hla Typing ◽  
Illumina Hiseq ◽  
Peripheral Blood Mononuclear ◽  
Leukocyte Antigen

2635 Background: Human leukocyte antigen (HLA) binding relies on energy from the interaction of B-pocket residues with anchor amino acids (AA). Among HLA class I supertypes, only HLA-B has distinct electrostatic B-pocket specificities, and of 7 HLA-B supertypes, B08, B27, and B44 feature binding pockets with preferences for charged AAs (Lund Immunogen). Whether electrostatic interactions in HLA-neoepitope binding would identify superior neoantigens and associate with survival in NSCLC patients treated with immunotherapy was unknown. Methods: Forty patients with advanced NSCLC treated with single agent pembrolizumab on a clinical trial with at least 5 years follow-up underwent paired tumor-normal whole-exome sequencing (WES) with Illumina HiSeq 2000/3000. HLA typing used normal (germline) WES from peripheral blood mononuclear cells analyzed with BWA-ALN and Athlates software (Liu Nuc Acids Res); supertype was determined by 2008 criteria (Sidney BMC Immunol). Tumor nonsynonymous coding mutations were identified with GATK v3.8, annotated with Ensembl-VEP, and passed through pVAC-Seq using a NetMHC 4.0 algorithm to identify potential neoepitopes 9 AAs in length (Hundal Genome Med). Neoepitopes were characterized based on mutant AA charge (D/E negative, H/K/R positive) and position. High affinity neoepitopes (HAN) were defined as those an with IC50 < 50 nM with wildtype IC50 > 50 nM (Ghorani Annals Oncol) and a mutation to a known B-pocket supermotif (K in position 3 or 5 for B08, R in position 2 for B27, E in position 2 for B44) (Lund Immunogen). Progression-free survival (PFS) was compared with logrank tests and proportional hazards (JMPv14, Cary, NC). Results: Of the 40 patients, 29 (72.5%) had at least one B08, B27, or B44 allele. One or more supertype-matched HAN were found in 10 of the 29 (34.5%), including 6/7 with PFS > 2 years, 3 of whom continue on therapy beyond 5 years. Median PFS in those with HAN was 26.7 months (m) vs 4.3 m in those without (HR 0.34, 95% CI 0.11-0.88, p = 0.024). Conclusions: Electrostatic charge may serve as a mechanism for enhanced binding affinity in HLA-B supertypes with a preference for charged AA in their B-pockets. Identification of favorable HLA-matched neoepitopes may identify distinct prognostic groups and potentially durable responders to immunotherapy in NSCLC.

Significance of a Single Human Leukocyte Antigen Mismatch on the Outcome of Nonmyeloablative Allogeneic Stem Cell Transplantation from Related Donors Using the Mexican Schedule.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5182-5182
Author(s):  
Guillermo J. Ruiz-Arguelles ◽  
Briceida López-Martínez ◽  
Carlos Manzano ◽  
J. D. Gómez-Rangel
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Human Leukocyte Antigen ◽  
Cell Transplantation ◽  
Chronic Gvhd ◽  
Conditioning Regimen ◽  
Human Leukocyte ◽  
Leukocyte Antigen ◽  
Nonmyeloablative Stem Cell Transplantation ◽  
Number Of Patients

Abstract The Mexican approach was used to conduct nonmyeloablative stem cell transplantation (SCT) in patients with various malignant and non-malignant hematologic diseases. Patients received a modified, low-intensity conditioning regimen, which included oral busulphan 4 mg/kg on Days −6 and −5, IV cyclophosphamide 350 mg/m2 on Days −4, −3, and −2, IV fludarabine 30 mg/m2 on Days −4, −3, and −2, oral cyclosporine A 5 mg/kg twice daily staring on Day −1 (continuing until Day 180), and IV methotrexate 5 mg/m2 on Days +1, +3, +5, and +11. Allografts were prospectively performed in 58 patients using sibling donors that were either human leukocyte antigen (HLA) identical (6/6) or compatible with 1 mismatch (5/6). In allografts where the donor was an HLA identical sibling (n = 40), the median overall survival was 33 months compared to 8 months when the donor was an HLA compatible sibling (n = 18; P <.01). The 52-month survival was 47% versus 38% in patients receiving allografts from HLA-identical donors and HLA-compatible donors, respectively. The prevalence of acute graft-versus-host-disease (GVHD) was 57% versus 38%, the prevalence of chronic GVHD was 25% versus 11%, and the relapse rate was 45% versus 55% in patients receiving allografts from HLA-identical donors and HLA-compatible donors, respectively. Two patients failed to engraft; both were 5/6 matches. Despite a trend toward less favorable results in patients allografted from HLA compatible (5/6) siblings, most differences in outcome were not significant, likely due to the small number of patients in the study. These data suggest that nonmyeloablative SCT using the Mexican approach may be a valid option for individuals with either an HLA identical or HLA compatible sibling donor.

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