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BACKGROUND: Chronic hepatitis C (CHC) is associated with altered cell-mediated immune response. OBJECTIVE: The aim of the study was to characterize functional alterations in CD4+ T cell subsets and myeloid-derived suppressor cells (MDSCs) during chronic hepatitis C virus (HCV) infection. Methodology. The expression levels of the lineage-defining transcriptional factors (TFs) T-bet, Gata3, Rorγt, and Foxp3 in circulating CD4+ T cells and percentages of MDSCs in peripheral blood were evaluated in 33 patients with CHC, 31 persons, who had spontaneously cleared the HCV infection, and 30 healthy subjects. Analysis. The CD4+ T cells TFs T-bet (T-box expressed in T cells), Foxp3 (Forkhead box P3 transcription factor), Gata3 (Gata-binding protein 3), and Rorγt (retinoic-acid-related orphan receptor gamma) and activation of CD8+ T cells, as well as percentages of MDSCs, were measured by multicolor flow cytometry after intracellular and surface staining of peripheral blood mononuclear cells with fluorescent monoclonal antibodies. RESULT: The patients with CHC had significantly lower percentages of CD4+ T cells expressing Rorγt and Gata3 and higher percentages of Foxp3-expressing CD4+ T cells than healthy controls and persons who spontaneously cleared HCV infection. The ratios of T-bet+/Gata3+ and Foxp3+/Rorγt+ CD4+ T cells were the highest in the patients with CHC. In the patients with CHC, the percentages of Gata3+ and Rorγt+ CD4+ T cells and the percentages of T-bet+ CD4+ T cells and CD38+/HLA-DR+ CD8+ T cells demonstrated significant positive correlations. In addition, the percentage of CD38+/HLA-DR+ CD8+ T cells correlated negatively with the percentage of MDSCs. CONCLUSION: Chronic HCV infection is associated with downregulation of TFs Gata3 and Rorγt polarizing CD4+ T cells into Th2 and Th17 phenotypes together with upregulation of Foxp3 responsible for induction of regulatory T cells suppressing immune response.
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OBJECTIVES: Genital herpes simplex virus (HSV) infection is controlled by HSV-specific T cells in the genital tract, and the role of systemic T cell responses is not fully understood. Thus, we analysed T cell responses in patients with recurrent genital herpes (GH). METHODS: T cell responses to HSV-1 and HSV-2 native antigens and the expression of HLA-DR and CD38 molecules on circulating CD8+ T cells were analysed in adults with high frequency of GH recurrences (19 patients) and low frequency of GH recurrences (7 patients) and 12 HSV-2 seronegative healthy controls. The study utilized the interferon-γ Elispot assay for measurement of spot-forming cells (SFC) after ex vivo stimulation with HSV antigens and flow cytometry for analysis of the expression of activation markers in unstimulated T cells. RESULTS: The patients with high frequency of GH recurrences (mean number of recurrences of 13.3 per year) had significantly enhanced HSV-specific T cell responses than the HSV-2 seronegative healthy controls. Moreover, a trend of higher numbers of SFC was observed in these patients when compared with those with low frequency of GH recurrences (mean number of recurrences of 3.3 per year). Additionally, no differences in CD38 and HLA-DR expression on circulating CD8+ T cells were found among the study groups. CONCLUSIONS: Frequency of GH recurrences positively correlates with high numbers of systemic HSV-specific T cells.
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The aim was to analyze T-regulatory cells (Tregs), activated CD8(+) T cells, and transforming growth factor-beta (TGF)-ß in hepatitis C patients. We enrolled 31 patients with chronic genotype 1 hepatitis C virus (HCV) infection, 30 seropositive persons with spontaneous HCV elimination, and 23 healthy volunteers. The patients were examined at the beginning of the interferon-alpha (IFN-α)-based therapy (baseline) and at weeks 4 (W4) and 12 (W12) of the therapy. The percentage of Tregs and the expression of activation markers CD38 and HLA-DR on CD8(+) T cells were analyzed in the peripheral blood by flow cytometry. Serum levels of TGF-ß were measured in a multiplex assay using flow cytometry. The percentage of Tregs in patients was higher than in controls and seropositive persons. Similarly, the percentage of CD8(+) T cells expressing CD38 and HLA-DR was higher in patients compared with controls and seropositive persons. Chronic HCV infection is associated with elevated circulating Tregs and activated CD8(+) T cells. During IFN-α-based therapy these cells gradually increase, whereas TGF-ß serum levels decrease.
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Antivirales/uso terapéutico , Linfocitos T CD8-positivos/inmunología , Hepatitis C Crónica/tratamiento farmacológico , Hepatitis C Crónica/patología , Activación de Linfocitos , Linfocitos T Reguladores/inmunología , Factor de Crecimiento Transformador beta/sangre , ADP-Ribosil Ciclasa 1/análisis , Adulto , Anciano , Linfocitos T CD8-positivos/química , Femenino , Citometría de Flujo , Genotipo , Antígenos HLA-DR/análisis , Hepacivirus/clasificación , Hepacivirus/genética , Hepatitis C Crónica/virología , Humanos , Inmunofenotipificación , Interferón-alfa/uso terapéutico , Masculino , Glicoproteínas de Membrana/análisis , Persona de Mediana Edad , Inhibidores de Proteasas/uso terapéutico , Ribavirina/uso terapéutico , Suero/química , Adulto JovenRESUMEN
BACKGROUND: An increasing incidence of endemic hepatitis E (HE) has been reported in developed countries. Thus, an evaluation of the clinical characteristics of the disease and the utility of the current diagnostic methods is warranted. METHODS: Fifty-one adult acute patients with HE hospitalized in a single center between the years 2009 and 2012 were evaluated. Serological and molecular techniques (detection of hepatitis E virus [HEV] RNA from stool and serum samples by quantitative reverse transcription polymerase chain reaction) with sequencing and phylogenetic analysis were used for diagnosis, and the clinical, laboratory, and epidemiological parameters of the patients were evaluated. RESULTS: Forty-nine (96.1%) patients had acute endemic HE and 2 (3.9%) had an imported infection. In the cohort of patients with acute symptomatic HE (n = 47), men outnumbered women (40:7), the patients were in older middle age (mean, 60.57 years), and they had elevated median values of total bilirubin (6.67 mg/dL), alanine aminotransferase (2288.82 U/L), aspartate aminotransferase (1251.76 U/L), gamma-glutamyl transferase (360.53 U/L), and alkaline phosphatase (197.06 U/L). Serology was positive in 50 (98%) of the patients, and 1 case was diagnosed by polymerase chain reaction only. HEV RNA was detected in at least 1 specimen from 84.3% of the patients, and 28 of 29 tested isolates belonged to genotype 3. The eating of meat, innards, other home-prepared pork products, or the tasting of raw meat before cooking were the most frequently reported data (reported by 25 patients [49.0%]). CONCLUSIONS: Large numbers of the endemic cases of HE were caused by HEV genotype 3, and the clinical characteristics of endemic HE were demonstrated.
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Enfermedades Endémicas , Virus de la Hepatitis E/aislamiento & purificación , Hepatitis E/epidemiología , Adulto , Anciano , República Checa/epidemiología , Heces/virología , Femenino , Genotipo , Anticuerpos Antihepatitis/sangre , Hepatitis E/patología , Virus de la Hepatitis E/clasificación , Virus de la Hepatitis E/genética , Humanos , Técnicas para Inmunoenzimas , Inmunoglobulina G/sangre , Incidencia , Masculino , Persona de Mediana Edad , ARN Viral/genética , ARN Viral/aislamiento & purificación , Análisis de Secuencia de ADN , Suero/virologíaRESUMEN
Routinely used biomarkers of bacterial etiology of infection, such as C-reactive protein and procalcitonin, have limited usefulness for evaluation of infections since their expression is enhanced by a number of different conditions. Therefore, several inflammatory cytokines and chemokines were analyzed with sera from patients hospitalized for moderate bacterial and viral infectious diseases. In total, 57 subjects were enrolled: 21 patients with community-acquired bacterial infections, 26 patients with viral infections, and 10 healthy subjects (control cohorts). The laboratory analyses were performed using Luminex technology, and the following molecules were examined: IL-1Ra, IL-2, IL-4, IL-6, IL-8, TNF- α , INF- γ , MIP-1 ß , and MCP-1. Bacterial etiology of infection was associated with significantly (P < 0.001) elevated serum concentrations of IL-1Ra, IL-2, IL-6, and TNF- α in comparison to levels observed in the sera of patients with viral infections. In the patients with bacterial infections, IL-1Ra and IL-8 demonstrated positive correlation with C-reactive protein, whereas, IL-1Ra, TNF- α , and MCP-1 correlated with procalcitonin. Furthermore, elevated levels of IL-1Ra, IL-6, and TNF- α decreased within 3 days of antibiotic therapy to levels observed in control subjects. The results show IL-1Ra as a potential useful biomarker of community-acquired bacterial infection.
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Infecciones Bacterianas/sangre , Biomarcadores/sangre , Quimiocinas/sangre , Infecciones Comunitarias Adquiridas/sangre , Citocinas/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/metabolismo , Calcitonina/sangre , Péptido Relacionado con Gen de Calcitonina , Femenino , Humanos , Proteína Antagonista del Receptor de Interleucina 1/sangre , Interleucina-2/sangre , Interleucina-4/sangre , Interleucina-6/sangre , Interleucina-8/sangre , Masculino , Persona de Mediana Edad , Precursores de Proteínas/sangre , Factor de Necrosis Tumoral alfa/sangre , Adulto JovenRESUMEN
To determine the origin of hepatitis E virus in the Czech Republic, we analyzed patient clinical samples. Five isolates of genotypes 3e, 3f, and 3g were obtained. Their genetic relatedness with Czech strains from domestic pigs and wild boars and patient recollections suggest an autochthonous source likely linked to consumption of contaminated pork.
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Virus de la Hepatitis E/clasificación , Hepatitis E/virología , Filogenia , Adulto , Anciano , República Checa , Heces/virología , Femenino , Genotipo , Virus de la Hepatitis E/genética , Virus de la Hepatitis E/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Sistemas de Lectura Abierta/genética , ARN Viral/genéticaAsunto(s)
Síndrome de Guillain-Barré/complicaciones , Síndrome de Guillain-Barré/patología , Ictericia/diagnóstico , Anciano , Autoanticuerpos/sangre , Diagnóstico Diferencial , Síndrome de Guillain-Barré/tratamiento farmacológico , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Ictericia/complicaciones , Masculino , Vaina de Mielina/inmunología , Cuadriplejía/diagnósticoRESUMEN
We report 3 cases of disease - leptospirosis, tropical malaria and fulminant meningococcaemia - associated with high serum concentrations of heparin-binding protein (HBP) and haemodynamic instability. Furthermore, HBP kinetics were observed for the first 3 days in survivors and were correlated with improvement in clinical condition.
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Péptidos Catiónicos Antimicrobianos/sangre , Proteínas Portadoras/sangre , Sepsis/complicaciones , Choque/diagnóstico , Adolescente , Adulto , Bacteriemia/complicaciones , Biomarcadores , Proteínas Sanguíneas , Femenino , Humanos , Malaria/complicaciones , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Acute acalculous cholecystitis is a rare complication of Epstein-Barr virus mononucleosis and involves thickening of the gallbladder wall. CASE REPORT: We describe the case of a 22-year-old woman with acute acalculous cholecystitis and pericholecystitis associated with Epstein-Barr virus primary infection. Surgical intervention was not performed, even though gallbladder perforation was suspected. The patient was treated conservatively with careful monitoring, including repeated ultrasonographic examinations. CONCLUSIONS: Epstein-Barr virus infections are usually self-limited, and surgical treatment of acute acalculous cholecystitis should only be considered when the ultrasonographic criteria persist on follow-up examinations or when they deteriorate. This is the first report of a severe course of acute acalculous cholecystitis with suspected gallbladder perforation associated with infectious mononucleosis.
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Colecistitis Alitiásica/complicaciones , Colecistitis Alitiásica/virología , Colecistitis Aguda/complicaciones , Colecistitis Aguda/virología , Infecciones por Virus de Epstein-Barr/complicaciones , Mononucleosis Infecciosa/complicaciones , Mononucleosis Infecciosa/virología , Colecistitis Alitiásica/diagnóstico por imagen , Adulto , Colecistitis Aguda/diagnóstico por imagen , Infecciones por Virus de Epstein-Barr/diagnóstico por imagen , Infecciones por Virus de Epstein-Barr/virología , Femenino , Vesícula Biliar/diagnóstico por imagen , Vesícula Biliar/patología , Humanos , Mononucleosis Infecciosa/diagnóstico por imagen , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
The review is aimed at the importance of determining procalcitonin serum levels (S-PCT) in numerous infectious and non-infectious diseases. Detecting increased S-PCT is particularly important for differential diagnosis of systemic bacterial as well as fungal infections. High S-PCT concentrations are also of predictive value in severe sepsis and septic shock. S-PCT kinetics may be used for monitoring the effect of antibiotic therapy. When compared to the other routinely used markers of bacterial infection (i.e. C-reactive protein, white blood cell count and neutrophil percentage), S-PCT has higher sensitivity and specificity in predicting bacterial infection.
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Infecciones Bacterianas/diagnóstico , Biomarcadores/sangre , Calcitonina/sangre , Precursores de Proteínas/sangre , Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Péptido Relacionado con Gen de Calcitonina , Diagnóstico Diferencial , HumanosRESUMEN
Splenectomy significantly impairs the immunity of the body; in a certain proportion of the patients this may cause the so-called OPSI (overwhelming post-splenectomy infection) syndrome, i. e. incidence of fulminant life-threatening infections. Even today, despite highly efficacious sophisticated antibiotics, this condition is burdened with very high mortality. In our paper we describe the management and preventive measures in splenectomized subjects at the Department of Infectious Diseases of the Teaching Hospital Brno.
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Antibacterianos , Esplenectomía , Humanos , IncidenciaRESUMEN
The authors are presenting a case of young female with Marseille fever contracted in Spain. The clinical manifestation of the illness was characterized by fevers, exanthema, headache and a typical skin rash ("the black spot") and prompted the authors to strongly consider the diagnosis of Marseille fever and to initiate appropriate antibiotic therapy. The diagnosis was confirmed later by serology. The article introduces new taxonomy of Rickettsial species and presents an overview and epidemiological aspects of specific diseases caused by them. The clinical manifestation, diagnosis and treatment of Marseille fever are discussed in greater detail.