Circulating functional T cells specific to human herpes virus 6 (HHV6) antigens in individuals with chromosomally integrated HHV6

Circulating functional T cells specific to human herpes virus 6 (HHV6) antigens in individuals with chromosomally integrated HHV

The bone marrow represents an enrichment site of specific T lymphocytes against filamentous fungi

Bone marrow has already been described as an enrichment site for several antigen-specific T lymphocytes, but the presence of mould-specific T cells has never been investigated in the bone marrow. We have previously demonstrated that mould-specific T cells emerge in the peripheral blood of patients with invasive fungal infections (IFI) but tend to become undetectable after disease resolution. In seven patients with a history of IFI, we investigated the presence of mould-specific T cells secreting different cytokines in bone marrow and peripheral blood paired samples. The results showed that the frequencies of mould-specific T cells secreting the protective cytokine IFNI3 are significantly higher in bone marrow (BM) and are mainly represented by CD8+ T lymphocytes with effector phenotype. A putative disappearance of such protective BM responses after myeloablative therapy could contribute to the increased risk of IFI in hematologic patients

Micro and Nanoparticles As Possible Causative-Prognostic Co-Factors Of Mixed Cryoglobulinemia Syndrome

Background/Purpose: We previously demonstrated that patients affected by membranoproliferative glomerulonephritis and mixed cryoglobulinemia syndrome (MCs) show the presence of circulating micro and nanoparticles (MPs and NPs) as possible causative/prognostic co-factors. This pilot study aimed to evaluate the possible role of occupational/environmental agents in the etiopathogenesis of MCs by investigating the patients’ exposure to both MPs and NPs. Methods: We investigated 20 consecutive HCV-positive MCs patients without renal involvement compared to 10 healthy, sex-/age-matched volunteers. All subjects completed a questionnaire concerning demographic data, dietary and smoking habits, prosthesis implants, air pollution, occupational and medical history. Environmental Scanning Electron Microscopy (ESEM) has been employed to detect inorganic MPs and NPs and to evaluate their presence in subjects with and without MCs. Energy Dispersive X-ray Spectroscopy (EDS) microanalysis was used to chemically characterize the elemental composition of the particles. Blood serum samples were spotted on metal free cover slips in a sterile environment. The complex of particles (MPs and NPs) was quantified using the number of spots (NS) containing inorganic particles in a fixed mapping area for each sample. Levels of NS were assessed statistically with Mann-Whitney U test. Results: Patients displayed higher serum levels of MPs/NPs particles (NS 36.6718.18, p0.0003), compared to controls (NS 5.626.25), independently of smoking habits. A direct correlation between the presence of particles and patients occupational exposure, environmental pollution and prosthesis implants was found. EDS microanalysis revealed that the particles have complex compositions, which includes several elements like Si, Fe, Al, Ti, Zn, Cu, Mn, and Ni. Conclusion: The ESEM analyses were a valuable tool to detect particulate matter in the serum samples. The complex of MPs/NPs particles was greater in MCs patients than in healthy subjects. These preliminary data suggest that, in addition to HCV infection, particulate complex might represent an environmental co-factor in the etiopathogenesis of MCs

Cryoglobulin evaluation: analysis of intra-laboratory and inter-laboratory variability

Background Cryoglobulins (CRG) are immunoglobulins that precipitate in serum at temperatures below 37°C and resolubilize upon warming. The main reasons of interest of a clinical pathologist in the study of cryoglobulinemia are: 1) lack of standardisation in the preanalytical, analytical and postanalytical phases of the process (classification and reporting); 2) peculiarities of physiopathological mechanism 3) important clinical consequences. Vermeersch et al. studied these issues in 2008. To assess current practice in the detection, analysis, and reporting of cryoglobulins, a questionnaire was sent to 140 laboratories. They showed that only 36% of laboratories used standard procedures of analysis. Consequently, they concluded that standardisation was needed for cryoglobulin detection to avoid missed diagnoses and improve the comparability of results. Sargur et al. in 2010 reviewed the classification and clinical features of cryoglobulins and suggested “best practice” guidelines for laboratory detection and identification of cryoglobulins. They particularly highlighted the relevance of preanalytical and analytical phases: maintenance of the sample at a stable temperature of 37°C, especially throughout the initial steps (collection and transportation); centrifugation and separation methods; cryoprecipitate quantification; cryoprecipitate washing techniques; immunocharacterization of cryoprecipitates especially through immunofixation techniques (considered the “gold standard”). Objectives To verify and assess the variability of laboratory processes of CRG. Methods We checked laboratory databases of Hospital and University (Lab A and B) of Modena with long tradition in the cryoglobulin analysis (more than 6000 tests from 2002 to 2017). Concerning CRG testing, 734 patient samples were studied in both laboratories. We compared our results according to Brouet classification into subgroups: type I, II and III. Therefore, we evaluated intra-laboratory variability, compared to previous or more frequent results. Finally, we studied inter-laboratory variability based on non-concordant laboratory reports. Results In the following table, we have represented the comparison between labs about the same patient cohort in 734 patient samples:Conclusions No data about variability in CRG analysis are reported in literature. National and international guidelines are not explicative enough. Furthermore, many doubts about classifications are established. Our experience is unique but limited in two laboratories. Given the variability of testing conditions used in different laboratories and the lack of test standards and reference values, we confirm the need of further investigations into standardisation of CRG testing. New guidelines are fundamental, in order to optimise all phases of CRG research (pre and post analysis) and to ensure correct diagnosis and adequate treatments of the associated diseases

Effectiveness of originator (Neupogen) and biosimilar (Zarzio) filgrastim in autologous peripheral blood stem cell mobilization in adults with acute myeloid leukemia: a single-center retrospective study

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