Search

Context.--Serologic tests on automated immunology analyzers are increasingly used to monitor acquired immunity against SARS-CoV-2. The heterogeneity of assays raises concerns about their diagnostic performance and comparability. Objective.--To test sera from formerly infected individuals for SARS-CoV-2 antibodies by using 6 automated serology assays and a pseudoneutralization test (PNT). Design.--Six SARS-CoV-2 serology assays were used to assess 954 samples collected during a 12-month period from 315 COVID-19 convalescents. The tests determined either antibodies against the viral nucleocapsid (anti-NC) or spike protein (anti-S). Two assays did not distinguish between antibody classes, whereas the others selectively measured immunoglobulin G (IgG) antibodies. PNT was used to detect the presence of neutralizing antibodies. Results.--Comparison of qualitative results showed only slight to moderate concordance between the assays (Cohen [kappa] < 0.57). Significant correlations (P < .001) were observed between the antibody titers from all quantitative assays. However, titer changes were not detected equally. A total anti-S assay measured an increase in 128 of 172 cases (74%) of a suitable subset, whereas all IgG anti-S tests reported decreases in at least 118 (69%). Regarding the PNT results, diagnostic sensitivities of 89% or greater were achieved with positive predictive values of at least 93%. In contrast, specificity changed substantially over time, varying from 20% to 100%. Conclusions.--Comparability of serologic SARS-CoV-2 antibody tests is rather poor. Owing to different diagnostic specificities, the tested assays were not equally capable of capturing changes in antibody titers. However, with thoroughly validated cutoffs, IgG-selective anti-S assays are a reliable surrogate test for SARS-CoV-2 neutralizing antibodies in former COVID-19 patients. (Arch Pathol Lab Med. 2022;146:538-546; doi: 10.5858/arpa.2021-0604-SA), The COVID-19 pandemic has motivated diagnostic manufacturers to develop tests that are useful to detect the serologic response to SARS-CoV-2 infection. The assays were developed in a very short time, [...]

Background: There is a narrow therapeutic window for immunosuppression using calcineurin inhibitors. Drug trough levels do not reflect immunosuppression and should be replaced by pharmacodynamic monitoring. This prospective cohort study was designed to evaluate the effect of an extended-release formulation of tacrolimus (LCP Tac) on the nuclear factor of activated T cell-regulated gene expression (NFAT-RGE). Methods: The expression of interleukin-2, interferon-γ, granulocyte-macrophage colony-stimulating factor, and three reference genes was measured. Samples from 23 patients at defined time points in the first year after liver transplantation were analyzed using a droplet digital polymerase chain reaction. Results: All samples were within the targeted trough levels of LCP Tac, and their LCP Tac peak levels and residual NFAT-RGE showed a strong inverse correlation (r = −0.8). Most importantly, there was an individual immunosuppressive response to the LCP Tac. The mean individual trough effect of LCP Tac on the three target genes when all time points were pooled was 33% (26–56%) in patients without infection and 81% (53–95%) in those with infection (p < 0.011). The mean individual peak effect was 48% (44–64%) in patients without infection and 91% (90–94%) in those with infection (p < 0.001). Conclusions: Thus, tailored immunosuppression based on residual NFAT-RGE could prevent infections associated with over-immunosuppression early after liver transplantation. [ABSTRACT FROM AUTHOR]

Introduction: Regular whole blood donors often suffer from iron deficiency (ID) or iron deficiency anemia due to the loss of 200–300 mg of iron with each donation. Hemoglobin (Hb) as donor eligibility criterion reflects iron stores only poorly. ID in blood donors is typically prevented or treated with orally administered ferrous salts, which frequently cause gastrointestinal side effects. A high daily oral iron dose is counterproductive due to hepcidin upregulation. Oral sucrosomial iron (sucriron) is encapsulated ferric pyrophosphate that may be an option for blood donors due to its supposed high bioavailability and good tolerability. Methods: This monocentric single-cohort pilot study included fifty whole blood donors (divided into premenopausal women, postmenopausal women, and men) who did not meet Hb donation criteria. Participants aged 18–65 years with ferritin <30 ng/mL and venous Hb <12.5 g/dL in women and Hb <13.5 g/dL in men received oral sucriron (30 mg iron) for 90–120 days. Primary endpoints were the increase of Hb and ferritin. Results: Forty-seven participants completed the study. With the limitation that no control group was included, there was a substantial overall median increase of 0.94 g/dL Hb and 4.97 ng/mL ferritin (standardized on 90 days of iron intake). These value improvements were likewise observed in each of the subgroups. sucriron was very well tolerated, with almost no gastrointestinal side effects identified. Conclusion: A clear increase of Hb and ferritin was observed after the intake of sucriron, so it may be a reasonable and useful alternative to traditional oral iron therapy. The ease of administration, pleasant taste, dietary supplement status, and, most importantly, good tolerability highlight the value of sucriron supplementation. [ABSTRACT FROM AUTHOR]

Background: The application of blood concentrates has gained popularity in dentistry in recent years. Platelet-rich fibrin (PRF) has been discussed frequently due to a high content of growth factors and the option of chair-side manufacturing in a simple centrifugation process. PRF is free from adjuvants and inexpensive to produce. The number of studies reporting beneficial effects of PRF in various clinical applications such as alveolar ridge preservation, sinus floor elevation, management and prevention of medical-related osteonecrosis of the jaw, third molar extractions, and guided bone regeneration in dentistry has increased recently. However, to date, neither clinical recommendations nor guidelines are available. The present narrative review aims to summarize the level of evidence on the clinical application of PRF within the field of oral surgery and implantology. Summary: A literature search in Pubmed and Medline has identified 34 articles as a basis for this narrative review. The effectiveness of the clinical application of PRF has been analyzed for five indications within dentistry: medical-related osteonecrosis of the jaw, wisdom tooth extraction, guided bone regeneration, sinus floor elevation, and alveolar ridge preservation. The amount of data for third molar extractions, socket preservation, and guided bone regeneration is extensive. Less data were available for the use of PRF in combination with sinus floor elevations. There is a lack of studies with scientific evidence on PRF and medical-related osteonecrosis of the jaw; however, studies positively impact patient-related outcome measures. Most studies report on beneficial effects when PRF is additionally applied in intrabony defects. There is no evidence of the positive effects of PRF combined with bone graft materials during sinus floor elevation. However, some benefits are reported with PRF as a sole filling material. Key Messages: Many recently published studies show the positive clinical impact of PRF. Yet, further research is needed to ensure the validity of the evidence. [ABSTRACT FROM AUTHOR]

Keywords: COVID-19; type 1 diabetes; type 2 diabetes; vaccination EN COVID-19 type 1 diabetes type 2 diabetes vaccination 314 318 5 12/13/22 20230101 NES 230101 CONTEXT Up to 1 June 2022, almost 12 billion vaccine doses for coronavirus disease 2019 (COVID-19) were administered worldwide.[1] People with diabetes were more probable to be hospitalized for COVID-19 and were observed to have in-hospital mortality as high as 25%.[[2]] Hence COVID-19 vaccination is not only recommended with priority in people with diabetes, it has also been shown to be effective in people with diabetes.[[4]] Our research group previously showed that humoral immune response 2-3 weeks after the second COVID-19 vaccination is similar in people with type 1 diabetes, type 2 diabetes and healthy controls,[6] irrespective of glycaemic control. The prospective COVAC-DM cohort study However, the decline of the antibody levels after the vaccination appears to be more pronounced in people with diabetes irrespective of glycaemic control, suggesting that shorter vaccination intervals may be necessary in both people with type 1 and type 2 diabetes, with the latter group showing the lowest antibody levels 6 months after the second vaccination. GLO:EU1/01jan23:dom14855-fig-0001.jpg PHOTO (COLOR): 1 A, Median anti-severe acute respiratory syndrome coronavirus 2 spike protein (SARS-CoV-2S) antibody titres post-second vaccination and pre-third vaccination in healthy controls, type 1 diabetes and type 2 diabetes. [Extracted from the article]