Peripheral blood TIM-3 positive NK and CD8+ T cells throughout pregnancy : TIM-3/galectin-9 interaction and its possible role during pregnancy

Abstract Problem: The T-cell immunoglobulin and mucin domain (TIM) family is a relatively newly described group of molecules with a conserved structure and important immunological functions. Identification of Galectin-9 as a ligand for TIM-3 has established the Galectin-9/TIM-3 pathway as an important negative regulator of Th1 immunity and tolerance induction. Data about the TIM-3/Gal-9 pathway in the pathogenesis of human diseases is emerging, but their possible role during human pregnancy is not precisely known. The aim of our study was to investigate the number, phenotype and functional activity of TIM-3+ peripheral blood mononuclear cells during healthy human pregnancy. Methods of Study: 57 healthy pregnant women [first trimester (n = 16); second trimester (n = 19); third trimester (n = 22)] and 30 non-pregnant controls were enrolled in the study. We measured the surface expression of TIM-3 by cytotoxic T cells, NK cells and NK cell subsets as well as Galectin-9 expression by regulatory T cells by flow cytometry. We analyzed the cytokine production and cytotoxicity of TIM3+ and TIM3- CD8 T and NK cells obtained from non-pregnant and healthy pregnant women at different stages of pregnancy by flow cytometry. Serum Galectin-9 levels were measured by ELISA. Results: Our results show that the numbers of peripheral NK and cytotoxic T cells and their TIM-3 expression do not change between the first, second and third trimesters of pregnancy. Compared to non-pregnant individuals, regulatory T cells show higher level of Galectin-9 expression as pregnancy proceeds, which is in line with the level of Galectin-9 in the patients sera. Cytotoxic T cells, NK cells and NK cell subsets expressing TIM-3 molecule show altered cytokine production and cytotoxicity during pregnancy compared to non-pregnant individuals. Conclusion: Our results indicate that Galectin-9 expressing regulatory T cells, TIM-3+ cytotoxic T cells and NK cells could play an important role in the maintenance of healthy pregnancy

Paraneoplastic anti-NMDA receptor encephalitis in 1830?

Our aim was to identify patients with probable anti-NMDA receptor encephalitis among historical medical cases.A case report published in leading Hungarian-, German- and Italian-language medical journals in the early 1840s was revisited.In 1830, an 18-year-old, healthy woman suffered epileptic seizures, followed by a 6-day-long state characterized by catalepsy, unresponsiveness, motionless, and light breathing. Her symptoms regularly returned in the following 1.5 years. Meanwhile, a progressively growing huge abdominal tumor appeared. One day, she suddenly started vomiting a large amount of foul-smelling pus mixed with blood, accompanied by bone fragments. Pus mixed blood with some membranous substance was also evacuated through the anus and vagina. After this event, she completely recovered; 1.5 years later, she married and later gave birth to 3 healthy children. The patient remained healthy during the 11-year follow-up.We suggest that in the description of a paraneoplastic case, an anti-NMDA receptor encephalitis can be dated back as far as to the 19th century, with an especially rare type of resolution: the disappearance of the symptoms after the spontaneous elimination of an ovarian teratoma

Reguláló RNS és génexpressziós profil központi idegrendszeri demyelinisatióban: sclerosis multiplex vonatkozások = Regulatory RNA and gene expression profiling in demyelination and remyelination of the central nervous system: implications to multiple sclerosis

A projekt folyamán de- és remyelinisatio gén expresszióját és ennek poszt-traszkripciós szabályozását vizsgáltuk állatmodellben. Array és kvantitatív RT-PCR alkalmazásával 3 miRNS differenciált expresszióját észleltük a de- és remyelinisatio során: egy miRNS funkciója eddig nem volt ismert. Ez a miRNS a fejlődő idegrendszer corpus callosumában is differenciáltan expresszálódott, ami a myelinisatio szabályozásában játszott szerepére utalhat. A prediktív target géneket 5 adatbázis elemzésével vizsgáltuk, majd útvonalelemzést végeztünk. Microarray alkalmazásával vizsgáltuk a génexpressziót a de- és remyelinisalt corpus callosumban. Beállítottuk az in situ hybridisatiot a miRNS detektálására; jelenleg zajlik a csendesítés oligodendrocyta sejtvonalon. Az eredmények a de- és remyelinisatio géenexpressziós szabályozásának molekuláris mechanizmusát, génexpressziós és miRNS által szabályozott útvonalakat tárhatnak fel. Szintén zajlik génexpressziós array-ek eredményeinek összehasonlítása a demyelinisalt és a gyulladásos állatmodellekben, illetve sclerosis multiplex agyi plakkokból: ez degeneratív és gyulladásos biomarkerek azonosítását célozza, melyet az SM hosszú távú prognózis predikciójára alkalmaznánk. | We have examined de- and remyelination-related gene expression and its post-transcriptional regulation in an animal model of MS. By using array and quantitative RT-PCR, we have identified differential expression of 3 miRNAs during de- and remyelination: function of one miRNA has not been known. This particular miRNA was also differentially expressed during developmental myelination. We also screened for predictive target genes using 5 different databases, and performed pathway analysis. Furthermore gene expression in the de- and remyelinated corpus callosum has been also examined by microarray. In situ hybridisation has been established for detection of miRNAs, and we have started silencing experiments by establishing oligodendrocyte cell lines. Our results may reveal molecular pathways of gene expression and gene expression regulation related to de- and remyelination. We have also started comparing gene expression in degenerative and inflammatory models of MS, as well a sin MS plaques. These experiments may result in identification of novel degenerative and inflammatory biomarkers, which we can translate back to human MS and use in prediction of long-term prognosis

Intrasession and Between-Visit Variability of Retinal Vessel Density Values Measured with OCT Angiography in Diabetic Patients

In clinical practice the measurement error of an instrument has special importance in analyzing and interpreting data, and acknowledging limitations. The purpose of this study was to evaluate intrasession and between-visit reproducibility of OCT angiography measurements in diabetic patients. A total of 54 eyes of 27 diabetic patients underwent OCT angiography imaging. Foveal avascular zone (FAZ) area and superficial retinal vessel density (VD) at 3 mm were calculated using the AngioAnalytics software. Three consecutive images were acquired at first visit and one image 1 month later. Intrasession and between-visit reproducibility of parameters were characterized by intraclass correlation coefficient (ICC), coefficient of variation (CV), and coefficient of repeatability (CR) values. We measured excellent (>0.90) ICC values both in intrasession and between-visit comparisons. CV was higher for the FAZ area compared to VD both in intrasession (7.79% vs. 2.87%) and in between-visit (12.33% vs. 2.95%) comparisons. Between-visit CR value for VD was 4.53% (95% CI: 3.72-5.79%). These data suggest that OCT angiography shows excellent repeatability in diabetic patients, indicating that this non-invasive technology might be suitable for longitudinal assessment of microvascular complications

A femtoszekundumlézer-asszisztált szürkehályog-műtét eredményei az új 2.16-os szoftverrel és a módosított SoftFit® páciensi felszínnel

INTRODUCTION: Femtosecond laser-assisted cataract surgery improved the results of cataract surgeries. AIM: Outcome analysis of femtosecond laser-assisted cataract surgery using the novel 2.16 software and the SoftFit(R) Patient Interface. METHOD: The novel software and the newly developed Patient Interface were used in 100 eyes of 100 patients. RESULTS: Length of femtosecond laser pretreatment decreased to 45-60 seconds. The smaller size of the new patient interface resulted in easier docking even on pediatric eyes. Suction force used for docking decreased from 40-50 mmHg to 16-20 mmHg. Incidence rate of subconjunctival suffusion decreased from 40% to 15-20% and its clinical severity was reduced, too. No corneal microfolds evolved, thus the incidence rate of the free-floating capsulotomies increased from 30% to 97%. The total energy of femtosecond laser pretreatment was decreased by almost 50%. Corneal wounds had the desired structure, and they were easy to open and closed precisely. CONCLUSIONS: The SoftFit(R) patient interface and the novel software widened the possible uses of the femtosecond laser-assisted cataract surgery, e.g. in pediatric ophthalmology. Innovations improved the safety and the predictability of the method. Orv. Hetil., 2015, 156(6), 221-225

Szisztémás gyógyszerek szemészeti mellékhatásai

A különböző szerveket érintő betegségek gyógyításában szisztémásan alkalmazott gyógyszerek szemészeti mellékha- tásai lehetnek tünetmentes elváltozások, azonban látást veszélyeztető kórképek is, mint a toxikus retinopathia vagy az opticus neuropathia. A szemészeti szűrővizsgálatok során a mellékhatások korai felismerésével a további progresszió és a maradandó látáskárosodás az esetek többségében megelőzhető. Összefoglaló közleményünkben a klinikai gya- korlatban széles körben használt gyógyszerek leggyakoribb és legjelentősebb szemészeti mellékhatásait ismertetjük. Célunk a gyógyszereket felíró orvosok tájékoztatása a terápia lehetséges szemészeti szövődményeiről, a szemészeti vizsgálatok fontosságáról és rendszerességéről

Epeút- és epehólyag-gyulladás: diagnosztikus kritériumok és terápia

In developed countries, diseases of the gallbladder and the biliary tract count as some of the most frequent gastrointestinal disorders. The inflammation of the gallbladder/biliary tree is a potentially severe, even lethal condition that requires rapid diagnosis and early multidisciplinary approach to be treated. Although the frequency of these diseases is high, the treatment is not unified in Hungary yet. The aim of the evidence-based recommendation is to clarify the diagnostic criteria and severity grading of these diseases and to highlight the indications and rules of proper application of the numerous available therapeutic interventions. The recent guideline is based on the consensus of the Board members of the Endoscopic Section of the Hungarian Gastroenterology Society in contribution with renown experts of surgery, infectology as well as interventional radiology and it counts as a clear and easy applicable guide during the all-day healthcare practice. Our guidelines are based on Tokyo guidelines established on the basis of the consensus reached in the International Consensus Meeting held in Tokyo which were revised in 2013 (TG13) and in 2018 (TG18). Orv Hetil. 2023; 164(20): 770-787

Evaluation of Retinal Blood Flow in Patients with Monoclonal Gammopathy Using OCT Angiography

Background: Monoclonal gammopathy (MG) is characterized by monoclonal protein overproduction, potentially leading to the development of hyperviscosity syndrome. Objective: To assess retinal circulation using optical coherence tomography angiography (OCTA) parameters in patients with monoclonal gammopathy. Methods: OCTA measurements were performed using the Optovue AngioVue system by examining 44 eyes of 27 patients with MG and 62 eyes of 36 control subjects. Superficial and deep retinal capillary vessel density (VD SVP and DVP) in the whole 3 × 3 mm macular and parafoveal area, foveal avascular zone (FAZ) area, and central retinal thickness (CRT) were measured using the AngioAnalytics software. The OCTA parameters were evaluated in both groups using a multivariate regression model, after controlling for the effect of imaging quality (SQ). Results: There was no significant difference in age between the subjects with monoclonal gammopathy and the controls (63.59 ± 9.33 vs. 58.01 ± 11.46 years; p > 0.05). Taking into account the effect of image quality, the VD SVP was significantly lower in the MG group compared to the control group (44.54 ± 3.22% vs. 46.62 ± 2.84%; p < 0.05). No significant differences were found between the two groups regarding the other OCTA parameters (p > 0.05). Conclusions: A decreased superficial retinal capillary vessel density measured using OCTA in patients with MG suggests a slow blood flow, reduced capillary circulation, and consequent tissue hypoperfusion. An evaluation of retinal circulation using OCTA in cases of monoclonal gammopathy may be a sensitive method for the non-invasive detection and follow-up of early microcirculatory dysfunction caused by increased viscosity