33 results on '"Kartsios C"'
Search Results
2. Obtaining informed consent for haematopoietic cell transplantation. How much information is enough?
- Author
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Hotidou, A., Kartsios, C., Sakellari, I., Kalogiannidis, P., Fassas, A., and Anagnostopoulos, A.
- Published
- 2004
3. PF795 EXPLORING THE REAL-LIFE CLINICAL VALUE OF LOW DOSE DIRECT ANTICOAGULANTS FOR SECONDARY PREVENTION OF THROMBOEMBOLISM
- Author
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Saul, S., primary, McIlroy, G., additional, Smith, N., additional, Perrin, D., additional, Fair, S., additional, and Kartsios, C., additional
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- 2019
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4. 4.22 Exploring the Clinical Significance of a Positive Direct Antiglobulin Test in CLL: A Community Hospital Experience
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Spyrou, A., primary, Kartsios, C., additional, Papadopoulos, V., additional, Loukidis, K., additional, Papageorgiou, V., additional, Effraimidou, S., additional, Georgiou, E., additional, Korantzis, I., additional, and Kioumi, A., additional
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- 2011
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5. L-arginine supplementation does not affect chemically induced carcinogenesis and tumor growth in BALB-c mice
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Eleftheriadis, Th, Voyatzi, S., Sparopoulou, T., Kartsios, C., Yiannaki, E., Antoniadi, G., Vassilios Liakopoulos, and Galaktidou, G.
- Subjects
Original Article - Abstract
T-cell zeta-chain downregulation is common in various types of cancer and it is proposed as a mechanism of cancer immunosubversion. L-arginine consumption by arginase rich suppressor myeloid cells has been incriminated. The effect of L-arginine supplementation on chemically induced carcinogenesis and tumor growth in mice was evaluated.Eight-week old female BALB-c mice were used. Ten mice were injected i.m. with 0.6 mg methylcholanthrene (MCA) once. Ten mice were injected with MCA once and were receiving L-arginine supplementation (5% in animal drinking water) continuously during the study. Mice with cancer were sacrificed 12 weeks after.From the 10 MCA injected mice 6 developed sarcoma. From the 10 MCA injected mice that were receiving L-arginine supplementation 7 developed sarcoma. L-arginine supplementation did not affect MCA induced carcinogenesis (p=1.0, Fisher's exact test). The weight of tumors was not different between the tumors derived from mice that were or were not receiving L-arginine supplementation (1088.3+/-590.2 mg vs. 969.6+/-608.1 mg respectively, p=0.729, unpaired t-test).L-arginine supplementation does not affect chemically induced carcinogenesis and tumor growth in BALB-c mice. Although zeta-chain downregulation could be a mechanism of cancer immunosubversion there are enough other cancer immunosubversion mechanisms that were not overwhelmed by L-arginine supplementation. Additionally, except cancer immunosubversion, cancer immunoselection is another, possibly more significant, mechanism of tumor escape from immunosurveillance.
6. Caplacizumab for immune thrombotic thrombocytopenic purpura: real-world multicenter data.
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Gavriilaki E, Nikolousis E, Koravou EE, Dimou-Besikli S, Kartsios C, Papakonstantinou A, Mpanti A, Pontikoglou C, Kalpadaki C, Bitsani A, Tassi I, Touloumenidou T, Chatziconstantinou T, Papathanasiou M, Syrigou A, Ztriva E, Kaiafa G, Mandala E, Mellios Z, Karakasis D, Kourakli A, Symeonidis A, Kapsali E, Papadaki HH, Lalayanni C, and Sakellari I
- Abstract
Given the limited real-world data of caplacizumab, our multicenter real-world study was designed to assess the safety and efficacy of caplacizumab in immune thrombotic thrombocytopenic pupura (iTTP), compared to historic controls. We have studied 70 patients: 23 in the caplacizumab and 47 in the historic control group. Plasma exchange was applied in all episodes except for two patients that denied plasma exchange. Rituximab as first-line treatment was more common in the caplacizumab group compared to historic control. Caplacizumab (10 mg daily) was given at a median on day 7 (1-43) from initial diagnosis for 32 (6-47) dosages. In the caplacizumab group, a median of 12 (8-23) patients required plasma exchange sessions versus 14 (6-32) in the control group. Caplacizumab administration did not produce any grade 3 complications or major hemorrhagic events. After a median of 19.0 (2.6-320) months since the iTTP diagnosis, 5 deaths occurred (4 in the control group and 1 in the caplacizumab group, p = 0.310). Caplacizumab patients achieved early platelet normalization and ADAMTS13 activity normalization at the end of treatment. Relapse was observed only in 2/23 (9%) caplacizumab patients, compared to 29/47 (62%) historic controls ( p < 0.001). Overall, caplacizumab is safe and effective in treating iTTP, including cases refractory to plasma exchange, re-administration, and cases without previous plasma exchange treatment. No major hemorrhagic events were observed. Cessation of dosing guided by ADAMTS13 has ensured a low relapse rate., Competing Interests: AntS and ArgS have received grants, honoraria or travel support from Abbvie, Amgen, Bei-Gene, BMS, Gilead, Glaxo, Janssen, MSD, Pfizer, Roche, Sanofi, Servier, SOBI, Takeda. ChaK and ChrK have received honoraria from Pfizer, BMS, Bayer, Takeda. EG and CP have received honoraria from Sanofi. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gavriilaki, Nikolousis, Koravou, Dimou-Besikli, Kartsios, Papakonstantinou, Mpanti, Pontikoglou, Kalpadaki, Bitsani, Tassi, Touloumenidou, Chatziconstantinou, Papathanasiou, Syrigou, Ztriva, Kaiafa, Mandala, Mellios, Karakasis, Kourakli, Symeonidis, Kapsali, Papadaki, Lalayanni and Sakellari.)
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- 2023
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7. Diagnosis, management, and outcomes of venous thromboembolism in COVID-19 positive patients: a role for direct anticoagulants?
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Kartsios C, Lokare A, Osman H, Perrin D, Razaq S, Ayub N, Daddar B, and Fair S
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- Aftercare statistics & numerical data, Aged, Clinical Audit, Critical Care methods, Critical Care statistics & numerical data, Female, Fibrin Fibrinogen Degradation Products analysis, Fibrinolytic Agents administration & dosage, Humans, Male, Outcome and Process Assessment, Health Care, SARS-CoV-2 isolation & purification, Thrombolytic Therapy methods, Thrombolytic Therapy statistics & numerical data, United Kingdom epidemiology, COVID-19 blood, COVID-19 complications, COVID-19 epidemiology, Factor Xa Inhibitors administration & dosage, Heparin administration & dosage, Pulmonary Embolism diagnosis, Pulmonary Embolism drug therapy, Pulmonary Embolism etiology, Venous Thromboembolism diagnosis, Venous Thromboembolism drug therapy, Venous Thromboembolism etiology, COVID-19 Drug Treatment
- Abstract
Coronavirus disease 2019 (COVID-19) has been associated with an increased risk of thromboembolic complications due to systemic coagulation activation. Little is known about the role of direct anticoagulants (DOACs) in COVID-19 related thrombosis. In this audit we sought to distinguish COVID-19 hospitalised patients with a diagnosis of venous thromboembolism (VTE) and record their outcomes over a period of 3 months (01/02/2020-30/04/2020). A total of 1583 patients were diagnosed with laboratory proven COVID-19 disease. Amongst them, 38 patients (0.82%) suffered VTE (median age 68 years, male/female: 20/18). VTE was the presenting symptom on admission in 71%. Pulmonary embolism was diagnosed in 92% of patients; 5 patients required intensive care and 3 underwent thrombolysis. 27 patients received initial treatment with unfractionated heparin/low molecular weight heparin (LMWH) while 10 were treated with direct anticoagulants (DOACs). After a median follow up of 25 days, 29 (76%) patients were alive while 5 were still hospitalised. Most patients (83%) were discharged on DOACs, no VTE recurrence or bleeding was recorded post-discharge. Our results suggest that direct anticoagulants could be a safe and effective treatment option in selected COVID-19 positive patients who have suffered venous thromboembolism.
- Published
- 2021
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8. First case of near haploid philadelphia negative B-Cell acute lymphoblastic leukaemia relapsing as acute myeloid leukemia following allogeneic hematopoietic stem cell transplantation.
- Author
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Horgan C, Kartsios C, Nikolousis E, Shankara P, Kishore B, Lovell R, Murthy V, Rudzki Z, Dyer S, Holtom P, Thompson G, Kaparou M, Xenou E, Lloyd R, Venkatadasari I, and Kanellopoulos AG
- Abstract
Herein we present a female patient aged 61 with Philadelphia negative acute lymphoblastic leukaemia demonstrating near haploid karyotype and abnormal TP53 expression at diagnosis, who relapsed with lineage switch as Acute Monocytic Leukemia post allogeneic stem cell transplantation. Molecular analysis established that both neoplasms were derived from the same founder clone. The leukemic lineage switch phenomenon has recently re-attracted interest as mechanism of leukemic evasion post treatment with chimeric antigen receptor T-cells but there is paucity of data on its presence post allograft or following novel antibody treatments such as Inotuzumab Ozogamicin or Blinatumomab. Our proposition for cancer research is that near haploidy in ALL could be linked to leukemic stem cell plasticity evading stem cell transplantation and other immunotherapy approaches., Competing Interests: The authors declare no conflict of interest., (© 2020 University Hospitals Birmingham.)
- Published
- 2020
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9. Management of venous thromboembolism in patients experiencing direct oral anticoagulant treatment failure: a single-center review of practice and outcomes.
- Author
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McIlroy G, Smith N, Lokare A, Beale K, and Kartsios C
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- Administration, Oral, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Anticoagulants administration & dosage, Anticoagulants adverse effects, Heparin, Low-Molecular-Weight administration & dosage, Heparin, Low-Molecular-Weight adverse effects, Treatment Failure, Venous Thromboembolism therapy
- Abstract
Direct oral anticoagulants (DOACs) have gained in popularity over vitamin K antagonists for the treatment of venous thromboembolism, however their efficacy is not routinely monitored. It is therefore a clinical challenge to know how to respond when treatment with DOACs fails, and there is little formal guidance on how to manage these patients. We sought to characterize VTE patients who experienced DOAC failure at our institution, and rationalize subsequent treatment strategies. We collated the details of 54 consecutive patients with suboptimal response or breakthrough thrombosis on a DOAC, from our large specialist-led thrombosis clinic. Initial treatment changes were recorded, as well as long-term anticoagulation therapy and treatment outcomes. On first recognition of DOAC failure, 69% of patients were temporarily switched to therapeutic-dose low molecular weight heparin; most of the remaining patients were treated with an alternative DOAC regimen. After a limited period of parenteral treatment, 84% of patients returned to oral anticoagulation, the majority of whom experienced no further treatment failures. By the end of follow-up, 72% of patients were either on long-term DOAC therapy or had completed treatment altogether. In the absence of evidence or guidelines, brief rescue of anticoagulation with parenteral therapy can be an effective strategy when treatment with a DOAC fails.
- Published
- 2020
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10. Recurrent pregnancy-induced agranulocytosis; case report and literature review.
- Author
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Ahmed MZ, Murthy V, Shenouda A, Patni S, and Kartsios C
- Subjects
- Adult, Female, Humans, Leukocyte Count, Pregnancy, Agranulocytosis blood, Agranulocytosis drug therapy, Lenograstim administration & dosage, Pregnancy Complications, Hematologic blood, Pregnancy Complications, Hematologic drug therapy
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- 2020
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11. Increased plasma angiogenin level is associated and may contribute to decreased T-cell zeta-chain expression in hemodialysis patients.
- Author
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Eleftheriadis T, Kartsios C, Pissas G, Liakopoulos V, Antoniadi G, Galaktidou G, and Stefanidis I
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- Aged, Base Sequence, C-Reactive Protein metabolism, Case-Control Studies, Down-Regulation, Enzyme-Linked Immunosorbent Assay, Female, Flow Cytometry, Humans, Interleukin-6 blood, Male, Middle Aged, Nephelometry and Turbidimetry, RNA, Messenger metabolism, Inflammation pathology, Renal Dialysis, Ribonuclease, Pancreatic blood, T-Lymphocytes immunology
- Abstract
Hemodialysis (HD) patients are characterized by impaired T-cell function at least in part because of T-cell zeta-chain downregulation due to inflammation. Angiogenin responds as an acute phase reactant, is increased in HD patients, suppresses T-cell function and increased angiogenin level is co-localized with T-cell zeta-chain downregulation in various pathologies. Angiogenin can inhibit translation of proteins, which lack internal ribosomal entry sites in the corresponding mRNAs. In this study, the possible effect of angiogenin on T-cell zeta-chain downregulation was evaluated. Thirty HD patients and 21 healthy volunteers participated. T-cell zeta-chain expression was assessed with flow cytometry, plasma angiogenin and serum IL-6 with ELISA and serum C-reactive protein with an immunoturbidimetric method. Two available software tools were used for predicting the presence or not of internal ribosomal entry sites in T-cell zeta-chain mRNA sequence. In silico analysis of T-cell zeta-chain mRNA sequence failed to reveal the presence of internal ribosomal entry sites. T-cell zeta-chain expression was lower in HD patients than in healthy volunteers (1.86 ± 0.63 vs. 4.73 ± 3.22). In HD patients, C-reactive protein as well as IL-6 were higher than in healthy volunteers (10.04 ± 15.13 mg/L vs. 3.43 ± 0.98 mg/L and 15.06 ± 13.08 pg/mL vs. 2.11 ± 2.10 pg/mL respectively). Angiogenin was higher in HD patients than in healthy volunteers (483.20 ± 154.07 ng/mL vs. 259.98 ± 64.15 ng/mL). Neither C-reactive protein, nor IL-6 was associated with angiogenin or T-cell zeta-chain expression. Angiogenin concentration was negatively related to the expression of T-cell zeta-chain (r = -0.410, P = 0.025). Increased angiogenin may contribute to decreased T-cell zeta-chain expression in HD patients., (© 2012 The Authors. Therapeutic Apheresis and Dialysis © 2012 International Society for Apheresis.)
- Published
- 2013
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12. Pyoderma gangrenosum in a patient with primary cutaneous peripheral T-cell lymphoma, not otherwise specified.
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Patsatsi A, Koletsa T, Sotiriadis D, Kartsios C, Papaconstantinou A, and Kostopoulos I
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- Aged, 80 and over, Anti-Inflammatory Agents therapeutic use, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cyclophosphamide administration & dosage, Cyclosporine therapeutic use, Dermatologic Agents therapeutic use, Doxorubicin administration & dosage, Fatal Outcome, Humans, Lymphoma, T-Cell, Cutaneous complications, Lymphoma, T-Cell, Cutaneous drug therapy, Male, Prednisolone administration & dosage, Prednisolone therapeutic use, Pyoderma Gangrenosum complications, Pyoderma Gangrenosum drug therapy, Skin Neoplasms complications, Skin Neoplasms drug therapy, Vincristine administration & dosage, Lymphoma, T-Cell, Cutaneous pathology, Pyoderma Gangrenosum pathology, Skin Neoplasms pathology
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- 2012
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13. A case of a primary cutaneous plasmacytoma presenting in adolescence.
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Koletsa T, Patsatsi A, Kostopoulos I, Kartsios C, Korantzis I, and Sotiriadis D
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- Biopsy, Diagnostic Errors, Female, Humans, Immunohistochemistry, Plasmacytoma immunology, Plasmacytoma pathology, Plasmacytoma surgery, Predictive Value of Tests, Skin Neoplasms immunology, Skin Neoplasms pathology, Skin Neoplasms surgery, Thigh, Young Adult, Plasma Cells immunology, Plasma Cells pathology, Plasmacytoma diagnosis, Skin Neoplasms diagnosis
- Abstract
Primary cutaneous plasmacytoma is defined as monoclonal proliferation of plasma cells that arises primarily in the skin without evidence of systemic disease. We present an extremely rare case of a young adult diagnosed with solitary plasmacytoma. A 20-year-old woman presented with a pruritic erythematosquamous indurated plaque on the inner aspect of her right thigh. She had undergone a biopsy 5 years ago, and under the diagnosis of Nekam disease, she was treated with topical steroids followed by intralesional injections of triamcinolone acetonide. A new skin biopsy revealed infiltration of the epidermis by small T lymphocytes while plasma cell accumulations were found in the dermis. Immunostains for light and heavy chains [kappa, lambda, immunoglobulin (Ig) G, IgA, and IgM] demonstrated IgG/κ monoclonality of the plasma cells. On molecular analysis, T-cell receptor and immunoglobulin heavy chain rearrangements were polyclonal. Serum protein electrophoresis, immunofixation, and quantitative assessment of serum Igs were normal. Bone marrow biopsy, skeletal survey, and body computed tomography scan were unremarkable. A diagnosis of primary solitary cutaneous plasmacytoma was made. The lesion was removed surgically, and the patient remains in remission up to now. Primary cutaneous plasmacytoma represents only 2%-4% of extramedullary plasmacytomas. The rarity and the nonspecific presentation of cutaneous plasmacytomas does not allow a definite clinical diagnosis. Only histopathology reveals the typical pattern of a dense monomorphic dermal plasmacytic infiltrate, whereas immunohistochemistry shows monoclonality of the neoplastic cells.
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- 2012
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14. Isolated Splenic Mycobacterial Disease: A Cause of Persistent Fever in a Hairy Cell Leukemia Patient.
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Papadopoulos V, Kartsios C, Spyrou A, Loukidis K, Miyakis S, Pervana S, Makridis C, Kioumi A, and Korantzis I
- Abstract
We describe a 69-year-old male patient who was referred for the investigation of long-lasting fever, anemia and neutropenia. Hairy cell leukemia was diagnosed and treated successfully. However, fever persisted despite thorough investigation and use of broad-spectrum antibiotics. Four months after the initial diagnosis, the patient underwent explorative laparotomy and splenectomy. Spleen biopsy revealed multiple necrotizing mycobacterial granulomata while the patient's fever disappeared permanently. Isolated splenic mycobacterial disease is very rare. This case report emphasizes that investigation of chronic fever in hairy cell leukemia requires a high level of clinical suspicion. Early diagnostic procedures for evidence of atypical mycobacterial infection should be considered. When everything else fails, surgery can be helpful in selected cases.
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- 2010
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15. Paricalcitol reduces basal and lipopolysaccharide-induced (LPS) TNF-alpha and IL-8 production by human peripheral blood mononuclear cells.
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Eleftheriadis T, Antoniadi G, Liakopoulos V, Kartsios C, Stefanidis I, and Galaktidou G
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- Adult, Cells, Cultured, Female, Humans, Leukocytes, Mononuclear immunology, Male, Ergocalciferols pharmacology, Interleukin-8 biosynthesis, Leukocytes, Mononuclear drug effects, Leukocytes, Mononuclear metabolism, Tumor Necrosis Factor-alpha biosynthesis
- Abstract
Introduction: Vitamin D and its analogues proved to exert immunomodulatory effects. Paricalcitol is a vitamin D analogue that is safe. It has been used for years in the treatment of secondary hyperparathyroidism in hemodialysis patients and, importantly, it is less calcemic than vitamin D. In this study the immunomodulatory/anti-inflammatory properties of paricalcitol were evaluated in vitro., Subject and Methods: Ten healthy volunteers enrolled into the study. Peripheral blood mononuclear cells (PBMC) at a concentration of 10(6) cells per well were cultured for 48 h in the presence or not of lipopolysaccharide (LPS) (100 ng/ml) and in the presence or not of paricalcitol (10(-8) M). TNF-alpha and IL-8 were measured in the supernatants by ELISA., Results: Basal TNF-alpha concentration (50.3 +/- 22 pg/ml) was reduced by paricalcitol (44.1 +/- 23.2 pg/ml). LPS increased TNF-alpha concentration (150.0 +/- 81.7 pg/ml), but paricalcitol reduced it (121.1 +/- 69.0 pg/ml). The effect of paricalcitol on IL-8 production was more profound. Basal IL-8 concentration (1926 +/- 455 pg/ml) was reduced by paricalcitol (1273 +/- 472 pg/ml). LPS increased IL-8 concentration (2361 +/- 385 pg/ml), but paricalcitol returned it to its basal level (1849 +/- 417 pg/ml)., Conclusion: The in vitro inhibition of transforming growth factor alpha and interleukin 8 by paricalcitol confirms the immunomodulatory properties of this vitamin D analogue.
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- 2010
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16. Decreased CD3+CD16+ natural killer-like T-cell percentage and zeta-chain expression accompany chronic inflammation in haemodialysis patients.
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Eleftheriadis T, Kartsios C, Yiannaki E, Antoniadi G, Kazila P, Pliakos K, Liakopoulos V, and Markala D
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- Adult, Aged, Aging immunology, C-Reactive Protein analysis, Chronic Disease, Female, Humans, Interleukin-6 blood, Male, Middle Aged, CD3 Complex analysis, Inflammation etiology, Kidney Failure, Chronic immunology, Killer Cells, Natural immunology, Receptors, Antigen, T-Cell analysis, Receptors, IgG analysis, Renal Dialysis
- Abstract
Aim: Clinical and experimental data indicate a deficient immune response in haemodialysis (HD) patients. Natural killer-like (NKL) T cells express on their surface both the T-cell antigen receptor (TCR) and a diverse set of NK-cell receptors (NKR) and share properties of both T cells and NK cells. zeta-Chain phosphorylation is an early event that follows TCR activation or some NKR activation. The zeta-chain of both T cell and NK cells is downregulated in many chronic inflammatory states, HD included. In the present study, NKL T-cell percentage and zeta-chain expression in HD patients were evaluated., Methods: Thirty-three stable HD patients and 30 healthy volunteers were enrolled into the study. NKL T-cell percentage and NKL T-cell zeta-chain mean fluorescence intensity (MFI) were evaluated with flow cytometry. The inflammatory markers C-reactive protein, interleukin-6 and tumour necrosis factor-alpha were measured in the serum by means of enzyme-linked immunosorbent assay., Results: All the evaluated markers of inflammation were increased in HD patients. In these patients, NKL T-cell percentage (1.71 +/- 1.69% vs 3.94 +/- 3.86%) and zeta-chain MFI (3.66 +/- 2.79 vs 7.03 +/- 7.91) were decreased., Conclusions: NKL T-cell percentage and zeta-chain expression is decreased in HD patients. Taking into consideration the continuously increasing age of the HD patients and that normally NKL T-cell numbers increase with age counteracting the impaired T-cell and NK-cell function accompanying advancing age, the above NKL T-cell disturbances could contribute to the impaired immune response in this population. Measures towards alleviating chronic inflammation could partially restore NKL T-cell impairment.
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- 2009
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17. The role of hepcidin in iron homeostasis and anemia in hemodialysis patients.
- Author
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Eleftheriadis T, Liakopoulos V, Antoniadi G, Kartsios C, and Stefanidis I
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- Anemia, Iron-Deficiency etiology, Hepcidins, Humans, Ion Transport physiology, Kidney Failure, Chronic metabolism, Anemia, Iron-Deficiency metabolism, Antimicrobial Cationic Peptides biosynthesis, Homeostasis physiology, Intestinal Absorption physiology, Iron metabolism, Kidney Failure, Chronic therapy, Renal Dialysis adverse effects
- Abstract
Anemia is a common complication in hemodialysis (HD) patients. Despite the great success of recombinant human erythropoietin in clinical practice, resistance to this therapy is common. Additionally, nephrologists frequently witness a rapid and significant drop in their patients' hematocrit during the course of various acute events that regularly take place in this sensitive population. Hepcidin, a recently identified peptide, may mediate this development in many instances. Hepcidin production is regulated by hypoxia/anemia, iron status, and importantly, inflammation. This peptide can block iron absorption by the duodenum, iron release from both the liver (the main iron storage pool) and, more significantly, the macrophages interrupting iron recycling between senescent red cells and the reticuloendothelial system. The decreased availability of iron for erythropoiesis leads to the anemia of chronic disease or, in HD patients, aggravate an already existing anemia HD is now widely considered an inflammatory state probably accounting for the increased serum hepcidin levels that have been associated with it. The physiology of hepcidin and its possible contribution to the pathogenesis of anemia in HD patients are the subject of this review.
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- 2009
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18. About the role of prohepcidin as an indicator of iron status in dialysis patients.
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Eleftheriadis T, Liakopoulos V, Kartsios C, Antoniadi G, Zarogiannis S, Markala D, and Stefanidis I
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- Anemia etiology, Biomarkers analysis, Case-Control Studies, Female, Hepcidins, Humans, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic therapy, Male, Reference Values, Renal Dialysis methods, Sensitivity and Specificity, Anemia diagnosis, Antimicrobial Cationic Peptides metabolism, Iron metabolism, Protein Precursors metabolism, Renal Dialysis adverse effects
- Published
- 2008
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19. Effect of one-year oral alpha-tocopherol administration on the antioxidant defense system in hemodialysis patients.
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Antoniadi G, Eleftheriadis T, Liakopoulos V, Kakasi E, Kartsios C, Passadakis P, and Vargemezis V
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- Administration, Oral, Antioxidants analysis, Erythrocytes enzymology, Female, Glutathione Peroxidase blood, Humans, Male, Middle Aged, Oxidative Stress physiology, Superoxide Dismutase blood, Oxidative Stress drug effects, Renal Dialysis adverse effects, alpha-Tocopherol administration & dosage
- Abstract
Oxidative stress is increased in hemodialysis (HD) patients and contributes to the increased morbidity and mortality in this population. Vitamin E is an antioxidant agent. In the present study the effect of prolonged oral alpha-tocopherol administration on the antioxidant defense system was evaluated. The antioxidant factors plasma total antioxidant status (TAS), red blood cell superoxide dismutase (SOD) activity and glutathione peroxidase (GPX) activity were evaluated with spectrometry in 27 HD patients. Measurements were performed before and after oral administration of alpha-tocopherol at a dose of 500 mg/d for a one-year period. Twenty HD patients received a placebo and 22 healthy volunteers served as controls. TAS was increased in HD patients. No difference was detected in SOD and GPX activity between HD patients and healthy volunteers. Tocopherol administration induced a significant decrease in TAS and SOD activity. Levels of GPX activity remained unaffected. All the evaluated factors remained stable in the HD patients receiving a placebo. Prolonged oral alpha-tocopherol administration in HD patients induces a decrease in some components of the antioxidant defense system, raising the possibility for a pro-oxidative role of vitamin E. Vitamin E is an antioxidant agent, but it is also known to have pro-oxidant action under special conditions that can be encountered in HD patients.
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- 2008
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20. Successful treatment of extramedullary gastric plasmacytoma with the combination of bortezomib and dexamethasone: first reported case.
- Author
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Katodritou E, Kartsios C, Gastari V, Verrou E, Mihou D, Banti A, Lazaraki G, Lazaridou A, Kaloutsi V, and Zervas K
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- Boronic Acids administration & dosage, Bortezomib, Dexamethasone administration & dosage, Humans, Male, Middle Aged, Plasmacytoma pathology, Plasmacytoma physiopathology, Pyrazines administration & dosage, Stomach Neoplasms pathology, Stomach Neoplasms physiopathology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Plasmacytoma drug therapy, Stomach Neoplasms drug therapy
- Abstract
We report a case of a 68-year-old man presented with upper-gastrointestinal bleeding. Endoscopy showed a large ulcerated gastric mass. Histological examination of the gastric biopsies revealed a k monoclonal extramedullary plasmacytoma (EMP). Further staging was negative for multiple myeloma. The patient was managed with bortezomib at a dose of 1.3mg/m2 on days 1, 4, 8 and 11 of a 21-day cycle in combination with dexamethasone 20mg p.o. on days 1, 2, 4, 5, 8, 9 and 11, 12 of each cycle. After 4 cycles of treatment, no endoscopic or histological findings of EMP were found. Thirteen months after diagnosis the patient is in complete remission with no evidence of local relapse or evolution to multiple myeloma. This is the first reported case of EMP successfully managed with the combination of bortezomib and dexamethasone.
- Published
- 2008
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21. The impact of chronic inflammation on bone turnover in hemodialysis patients.
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Eleftheriadis T, Kartsios C, Antoniadi G, Kazila P, Dimitriadou M, Sotiriadou E, Koltsida M, Golfinopoulos S, Liakopoulos V, and Christopoulou-Apostolaki M
- Subjects
- Aged, C-Reactive Protein analysis, Case-Control Studies, Chronic Disease, Chronic Kidney Disease-Mineral and Bone Disorder physiopathology, Disease Progression, Female, History, Ancient, Humans, Inflammation etiology, Inflammation Mediators blood, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic therapy, Linear Models, Long-Term Care, Male, Middle Aged, Multivariate Analysis, Probability, Prognosis, Renal Dialysis methods, Risk Assessment, Sensitivity and Specificity, Severity of Illness Index, Statistics, Nonparametric, Survival Analysis, Bone Remodeling physiology, Chronic Kidney Disease-Mineral and Bone Disorder etiology, Inflammation diagnosis, Interleukin-6 blood, Kidney Failure, Chronic complications, Renal Dialysis adverse effects
- Abstract
Background: Renal osteodystrophy is very common in hemodialysis (HD) patients. HD is a chronic inflammatory state. Studies in other pathological entities have shown an impact of chronic inflammation on bone metabolism. In the present study, the impact of chronic inflammation on bone turnover in HD patients was evaluated., Patients and Methods: Thirty-three anuric HD patients free of other pathological conditions or medications that affect immune system or bone metabolism and 30 healthy volunteers enrolled into the study. Intact parathyroid hormone (iPTH), the markers of inflammation IL-6 and CRP, as well as the markers of bone turnover osteocalcin (OCN) and beta-isomerized C-terminal cross-linked peptide of collagen type I (beta-CTx) were measured in the serum., Results: All evaluated factors were increased in HD patients. In the HD group, the serum marker of osteoblastic activity OCN was related inversely to patients' age (r = -0.469, p = 0.006), CRP (rho = -0.460, p = 0.007), and IL-6 (r = -0.485, p = 0.004) but positively to iPTH (r = 0.707, p < 0.001). Similarly, the serum marker of osteoclastic activity beta-CTx was related inversely to patients' age (r = -0.383, p = -0.028), CRP (rho = -0.466, p = 0.006), and IL-6 (r = -0.460, p = 0.007) but positively to iPTH (r = 0.657, p < 0.001). Multiple linear regression analysis revealed that IL-6 affects bone turnover independently of PTH and to the opposite direction., Conclusion: Chronic inflammation has a negative impact on bone turnover in HD patients. Certainly, further research and large clinical trials are needed for definite conclusions and for clarifying the exact molecular mechanisms implicated in the interaction between the immune system and bone metabolism in HD patients.
- Published
- 2008
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22. Chronic inflammation and CD16+ natural killer cell zeta-chain downregulation in hemodialysis patients.
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Eleftheriadis T, Kartsios C, Yiannaki E, Kazila P, Antoniadi G, Liakopoulos V, and Markala D
- Subjects
- Aged, Biomarkers analysis, CD3 Complex, Case-Control Studies, Chronic Disease, Down-Regulation, Female, Flow Cytometry, Humans, Lymphocyte Count, Male, Middle Aged, Receptors, IgG, Renal Dialysis, Inflammation pathology, Kidney Failure, Chronic pathology, Killer Cells, Natural pathology, Receptors, Antigen, T-Cell analysis
- Abstract
Background: Natural killer (NK) cell activity is decreased in hemodialysis (HD) patients. Zeta-chain phosphorylation is an early event that follows the triggering of some NK cell-activating receptors. NK cell zeta-chain is downregulated in patients with cancer due to chronic inflammation. HD is also a chronic inflammatory state. NK cell zeta-chain expression in HD was evaluated., Patients and Methods: Thirty-three HD patients and 30 healthy volunteers were enrolled into the study. The CD3-CD16+ subpopulation was examined, since it corresponds to 90% of all NK cells and has the highest cytotoxicity.NK cell count and zeta-chain mean fluorescence intensity were evaluated with flow cytometry. The inflammatory markers C-reactive protein, IL-6 and tumor necrosis factor-alpha were measured with ELISA., Results: The inflammatory markers were increased in HD patients. NK cell count did not differ between HD patients and healthy volunteers. NK cell zeta-chain mean fluorescence intensity was decreased in the patient group., Conclusions: Chronic inflammation could be responsible for the NK cell zeta- chain downregulation in HD patients, contributing to the decreased NK cell activity., ((c) 2008 S. Karger AG, Basel)
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- 2008
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23. Chronic inflammation and T cell zeta-chain downregulation in hemodialysis patients.
- Author
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Eleftheriadis T, Kartsios C, Yiannaki E, Kazila P, Antoniadi G, Liakopoulos V, and Markala D
- Subjects
- Aged, C-Reactive Protein metabolism, CD3 Complex metabolism, Chronic Disease, Down-Regulation immunology, Female, Humans, Kidney Failure, Chronic therapy, Lymphocyte Count, Male, Middle Aged, Phosphorylation, Renal Dialysis, Inflammation immunology, Kidney Failure, Chronic immunology, Membrane Proteins metabolism, Receptors, Antigen, T-Cell metabolism, T-Lymphocytes immunology, T-Lymphocytes metabolism
- Abstract
Background: Clinical and experimental data indicate a deficient immune response in hemodialysis (HD) patients. zeta-Chain phosphorylation is an early and central event in the process that follows antigen recognition by the T cell antigen receptor (TCR). T cell zeta-chain is downregulated in many chronic inflammatory states, such as cancer, autoimmune disease and chronic infection. HD is also characterized as a chronic inflammatory state. The aim of the present study was to evaluate T cell zeta-chain expression in HD patients., Patients and Methods: Thirty-three stable HD patients and 30 healthy volunteers were enrolled into the study. T cell count, the percentage of zeta-chain-positive T cells, as well as T cell zeta-chain mean fluorescence intensity (MFI) were evaluated with flow cytometry. The inflammatory markers C-reactive protein, interleukin-6 and tumor necrosis factor-alpha were measured in the serum by means of ELISA., Results: All the evaluated markers of inflammation were increased in HD patients. In these patients, T cell zeta-chain MFI was decreased. CD3-epsilon MFI did not differ between the two groups indicating that among the TCR complex constituents, zeta-chain is selectively downregulated., Conclusions: HD is a state of chronic inflammation. Like in other pathological chronic inflammatory conditions, T cell zeta-chain is downregulated in HD patients. Since zeta-chain plays a key role in the transduction of the signal that follows antigen recognition by the TCR, its downregulation could be responsible for the deficient cellular immune response observed in HD patients., ((c) 2007 S. Karger AG, Basel.)
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- 2008
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24. Disturbances of acquired immunity in hemodialysis patients.
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Eleftheriadis T, Antoniadi G, Liakopoulos V, Kartsios C, and Stefanidis I
- Subjects
- Humans, Kidney Failure, Chronic therapy, Prognosis, Quality of Life, Risk Factors, Antigen-Presenting Cells immunology, Immunity, Cellular immunology, Kidney Failure, Chronic immunology, Renal Dialysis, T-Lymphocytes immunology
- Abstract
Acquired immunity disturbances in hemodialysis (HD) patients are many and diverse. They are caused by uremia per se, the HD procedure, chronic renal failure complications, and therapeutic interventions for their treatment. Current data suggest that acquired immunity disturbances in HD patients concern mainly the T-lymphocyte and the antigen-presenting cell (APC). The T-lymphocyte-dependent immune response is deficient, predisposing to infections and inadequate response to vaccinations. In addition, APCs are preactivated, which seems to be responsible for the malnutrition-inflammation-atherosclerosis syndrome, and also affects T-lymphocyte function. At the molecular level it is assumed that the interaction between the APC and the T-lymphocyte is impaired. This disturbance is likely to concern the signal that results from the interaction between the major histocompatibility complex:peptide complex on APC surfaces and T-cell receptors on T-lymphocyte surfaces, or the signal that results from the interaction among the co-receptors of these two cells. The aim of the present review was to collect and classify the available clinical and experimental data in this area. Although many pieces are still missing from the puzzle, a better understanding of the responsible molecular mechanisms, will potentially lead to increased survival and a better quality of life in HD patients.
- Published
- 2007
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25. L-arginine supplementation does not affect chemically induced carcinogenesis and tumor growth in BALB-c mice.
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Eleftheriadis T, Voyatzi S, Sparopoulou T, Kartsios C, Yiannaki E, Antoniadi G, Liakopoulos V, and Galaktidou G
- Abstract
Unlabelled: T-cell zeta-chain downregulation is common in various types of cancer and it is proposed as a mechanism of cancer immunosubversion. L-arginine consumption by arginase rich suppressor myeloid cells has been incriminated. The effect of L-arginine supplementation on chemically induced carcinogenesis and tumor growth in mice was evaluated., Methods: Eight-week old female BALB-c mice were used. Ten mice were injected i.m. with 0.6 mg methylcholanthrene (MCA) once. Ten mice were injected with MCA once and were receiving L-arginine supplementation (5% in animal drinking water) continuously during the study. Mice with cancer were sacrificed 12 weeks after., Results: From the 10 MCA injected mice 6 developed sarcoma. From the 10 MCA injected mice that were receiving L-arginine supplementation 7 developed sarcoma. L-arginine supplementation did not affect MCA induced carcinogenesis (p=1.0, Fisher's exact test). The weight of tumors was not different between the tumors derived from mice that were or were not receiving L-arginine supplementation (1088.3+/-590.2 mg vs. 969.6+/-608.1 mg respectively, p=0.729, unpaired t-test)., Conclusion: L-arginine supplementation does not affect chemically induced carcinogenesis and tumor growth in BALB-c mice. Although zeta-chain downregulation could be a mechanism of cancer immunosubversion there are enough other cancer immunosubversion mechanisms that were not overwhelmed by L-arginine supplementation. Additionally, except cancer immunosubversion, cancer immunoselection is another, possibly more significant, mechanism of tumor escape from immunosurveillance.
- Published
- 2007
26. IgG multiple myeloma presented with ulcerative pyoderma gangrenosum.
- Author
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Verrou E, Kartsios C, Banti A, Mihou D, Kaloutsi V, Lazaridou A, and Zervas K
- Subjects
- Dexamethasone therapeutic use, Humans, Male, Middle Aged, Multiple Myeloma diagnosis, Multiple Myeloma drug therapy, Pyoderma Gangrenosum diagnosis, Pyoderma Gangrenosum drug therapy, Thalidomide therapeutic use, Ulcer, Multiple Myeloma complications, Pyoderma Gangrenosum complications
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- 2007
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27. Hypochromic erythrocytes (%): a reliable marker for recognizing iron-restricted erythropoiesis and predicting response to erythropoietin in anemic patients with myeloma and lymphoma.
- Author
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Katodritou E, Terpos E, Zervas K, Speletas M, Kapetanos D, Kartsios C, Verrou E, Banti A, Effraimidou S, and Christakis J
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Anemia, Iron-Deficiency etiology, Biomarkers, Erythrocytes classification, Erythropoietin pharmacology, Female, Hematinics pharmacology, Hematocrit, Humans, Lymphoma complications, Lymphoma drug therapy, Male, Middle Aged, Multiple Myeloma complications, Multiple Myeloma drug therapy, Predictive Value of Tests, Recombinant Proteins, Anemia, Iron-Deficiency drug therapy, Erythrocyte Indices drug effects, Erythrocytes chemistry, Erythropoiesis drug effects, Erythropoietin therapeutic use, Hematinics therapeutic use
- Abstract
The aim of the study was to evaluate the role of hypochromic erythrocytes (HYPO%) compared to "traditional" and novel markers of iron status and erythropoiesis in recognizing iron-restricted erythropoiesis (IRE) and predicting response to erythropoietin (rHuEPO) in anemic patients with myeloma and lymphoma. Forty-one newly diagnosed patients who received epoetin-beta at a subcutaneous weekly dose of 30,000 IU for 6 weeks were studied. Response to rHuEPO was observed in 27 patients (65.8%). Twelve non-responders received, additionally, 200 mg of IV iron sucrose, weekly, for 4 weeks. Evaluation of markers was performed at baseline and on weeks 1, 2 and 6 for all patients and also on weeks 7-10 for non-responders to rHuEPO. Baseline HYPO%, at a cut-off value of <5%, and an increment in reticulocyte absolute number (RETICS-AB) >or= 50,000/microl and reticulocyte hematocrit (RETICS-Hct) >or= 50%, between baseline and week 2, were independent predictive factors for response to rHuEPO. We found that these markers had superior predictive value for response to rHuEPO than four widely used predictive models. Furthermore, a baseline HYPO% count of above 5% proved superior over serum ferritin < 100 ng/ml and transferrin saturation < 20% in recognizing IRE. In conclusion, baseline HYPO% either alone or in combination with RETICS-AB or RETICS-Hct after 2 weeks of rHuEPO treatment could be reliably used in predicting response to rHuEPO. Additionally, HYPO% has proved a reliable marker for recognizing IRE before rHuEPO treatment and, thus, could be used for identifying patients who will benefit from IV iron supplementation.
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- 2007
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28. Association of CD38 expression and diagnostic immunophenotypic score in B cell chronic lymphocytic leukemia.
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Kartsios C, Yiannaki E, Eleftheriadis T, Katodritou E, Ditsa M, Zervas K, and Markala D
- Subjects
- Adult, Aged, Aged, 80 and over, Antigens, CD analysis, Biomarkers, Tumor analysis, Female, Glycoproteins analysis, Humans, Immunoglobulin Light Chains analysis, Leukemia, Lymphocytic, Chronic, B-Cell classification, Leukemia, Lymphocytic, Chronic, B-Cell diagnosis, Male, Middle Aged, Prognosis, ADP-ribosyl Cyclase 1 analysis, Antigens, Neoplasm analysis, B-Lymphocytes chemistry, Immunophenotyping, Leukemia, Lymphocytic, Chronic, B-Cell metabolism, Membrane Glycoproteins analysis
- Published
- 2007
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29. Reversible T-large granular lymphocyte expansion and neutropenia associated with adalimumab therapy.
- Author
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Theodoridou A, Kartsios C, Yiannaki E, Markala D, and Settas L
- Subjects
- Adalimumab, Antibodies, Monoclonal, Humanized, Arthritis, Rheumatoid drug therapy, Female, Humans, Immunophenotyping, Lymphocyte Subsets drug effects, Lymphocytosis classification, Middle Aged, T-Lymphocytes drug effects, Tumor Necrosis Factor-alpha antagonists & inhibitors, Antibodies, Monoclonal adverse effects, Immunologic Factors adverse effects, Lymphocytosis chemically induced, Neutropenia chemically induced
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- 2006
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30. Major histocompatibility complex class I restricted T-cell autoreactivity in human peripheral blood mononuclear cells.
- Author
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Eleftheriadis T, Voyatzi S, Antoniadi G, Kartsios C, Liakopoulos V, Paraskevopoulos P, and Galaktidou G
- Subjects
- Cell Proliferation drug effects, Cell Separation, Cells, Cultured, Cysteine Endopeptidases metabolism, Humans, Interferon-gamma pharmacology, Interleukin-2 metabolism, Lysosomes drug effects, Phosphorylation drug effects, Proteasome Inhibitors, Subcellular Fractions, T-Lymphocytes cytology, Autoimmunity immunology, Histocompatibility Antigens Class I immunology, T-Lymphocytes immunology
- Abstract
During selection in the thymus or any subsequent response, T-cells recognize peptides bound to major histocompatibility complex (MHC) molecules. Peptides produced by lysosomes or by proteasome/immunoproteasome stimulate CD4+ or CD8+ T-cell, respectively. Inflammation alters components of both antigen-processing pathways resulting in the production of different peptides. The role of such changes in self/non-self discrimination was examined in autologous mixed peripheral blood mononuclear cell cultures. Stimulator cells were incubated in the presence or absence of INF-gamma, with or without lysosome inhibitors (ammonium chloride/chloroquine), cathepsin inhibitor (E-64), or proteasome/immunoproteasome inhibitor (epoxomicin). Responder cells were added and zeta-chain phosphorylated forms were used as read out. INF-gamma did not affect zeta-chain phosphorylated forms, which means that the expected INF-gamma induced alterations in antigen processing machinery do not influence self/non-self discrimination. Surprisingly, the completely phosphorylated 23-kDa zeta-chain was always present except in the case of epoxomicin, indicating the presence of MHC class I restricted autoreactive CD8+ T-cells but not of MHC class II restricted autoreactive CD4+ T-cells, possibly due to more efficient negative selection in the thymus of the latter. Autoimmunity is prevented due to absence of help by CD4+ T-cells. This conclusion was confirmed by the lack of differences in IL-2 levels in cell culture supernatants, as well as, by the absence of differences in cell proliferation under the various conditions described above.
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- 2006
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31. Does hepcidin affect erythropoiesis in hemodialysis patients?
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Eleftheriadis T, Kartsios C, Liakopoulos V, Antoniadi G, Ditsa M, Papadopoulos C, Anifandis G, Skirta A, Markala D, and Stefanidis I
- Subjects
- Aged, Antimicrobial Cationic Peptides blood, Case-Control Studies, Erythropoiesis drug effects, Erythropoietin administration & dosage, Female, Hematocrit, Hepcidins, Humans, Iron administration & dosage, Iron metabolism, Linear Models, Male, Middle Aged, Protein Precursors blood, Antimicrobial Cationic Peptides physiology, Erythropoiesis physiology, Protein Precursors physiology, Renal Dialysis
- Abstract
Introduction: Prohepcidin is the precursor of hepcidin, a liver-derived peptide involved in iron metabolism by blocking its intestinal absorption and its release by the reticuloendothelial system. Iron overload and inflammation increase hepcidin expression, whereas anemia and hypoxia suppress it. In the present study prohepcidin levels were determined in the serum of hemodialysis (HD) patients and its correlations with iron metabolism markers, C-reactive protein (CRP) and hematocrit (Hct) were assessed., Patients and Methods: Forty-sixHD patients and 22 healthy volunteers were enrolled in the study. Hct, serum prohepcidin, CRP, iron, ferritin, transferrin saturation and transferrin receptors were measured. The weekly erythropoietin dose, last-month intravenous iron dose and the patients' demographics were recorded., Results: In comparison to the healthy volunteers, the HD patients had higher serum ferritin, transferrin receptors and CRP, lower serum iron and similar transferrin saturation and prohepcidin levels. In the patient group prohepcidin levels were negatively correlated with Hct but not with any other of the examined parameters. Multiple linear regression analysis considering age, inflammation, iron adequacy, erythropoietin dose and prohepcidin levels revealed that prohepcidin was the predominant determinant of Hct., Conclusions: Taking into account the low Hct levels in the HD patients of our study, it seems plausible that the prohepcidin levels assessed in this group are inappropriately high. These functionally high prohepcidin levels may be associated with the factors that inhibit erythropoiesis in HD patients. On the other hand, the absence of other expected correlations indicates that further studies are needed in order to definitely clarify this aspect., (Copyright 2006 S. Karger AG, Basel.)
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- 2006
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32. Can we expect something from prohepcidin measurement in hemodialysis patients?
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Eleftheriadis T, Liakopoulos V, Kartsios C, Antoniadi G, Markala D, and Stefanidis I
- Subjects
- Adult, Aged, Aged, 80 and over, Enzyme-Linked Immunosorbent Assay, Erythropoietin administration & dosage, Erythropoietin blood, Female, Hematocrit, Hepcidins, Humans, Inflammation blood, Injections, Subcutaneous, Interleukin-6 blood, Male, Middle Aged, Predictive Value of Tests, Antimicrobial Cationic Peptides blood, Erythropoiesis drug effects, Iron blood, Protein Precursors blood, Renal Dialysis
- Published
- 2006
- Full Text
- View/download PDF
33. Spontaneous adrenal haemorrhage as a manifestation of isolated relapse of non-Hodgkin's lymphoma.
- Author
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Kartsios C, Kaloyannidis P, Yannaki E, Iordanidis P, Penopoulos V, Sakellari I, and Anagnostopoulos A
- Subjects
- Adrenal Gland Diseases complications, Adult, Female, Hemorrhage complications, Humans, Lymphoma, Large B-Cell, Diffuse physiopathology, Magnetic Resonance Imaging, Recurrence, Adrenal Gland Diseases diagnosis, Hemorrhage diagnosis, Lymphoma, Large B-Cell, Diffuse complications
- Abstract
Retroperitoneal haemorrhage due to metastatic disease is a rare event not previously reported in lymphomas. We describe a 36-year-old woman diagnosed with diffuse large B cell lymphoma (DLBCL) of bone marrow, liver and spleen presenting in the leukaemic phase. The patient attained complete remission after 'ALL-like' chemotherapy (cyclophosphamide, vincristine, adriamycin, dexamethasone); 22 months later, she developed an isolated central nervous system (CNS) relapse which was successfully managed with a combination of chemotherapy and CNS irradiation. Six months later, she was rehospitalized because of abdominal pain; an MRI revealed a large haemorrhagic mass in the left adrenal. Surgical removal of the lesion confirmed an adrenal relapse of the primary DLBCL., (Copyright 2003 S. Karger AG, Basel)
- Published
- 2003
- Full Text
- View/download PDF
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