The combination of arsenic, interferon-alpha, and zidovudine restores an “immunocompetent-like” cytokine expression profile in patients with adult T-cell leukemia lymphoma

BACKGROUND: HTLV-I associated adult T-cell leukemia/lymphoma (ATL) carries a dismal prognosis due to chemo-resistance and immuno-compromised micro-environment. The combination of zidovudine and interferon-alpha (IFN) significantly improved survival in ATL. Promising results were reported by adding arsenic trioxide to zidovudine and IFN. RESULTS: Here we assessed Th1/Th2/T(reg) cytokine gene expression profiles in 16 ATL patients before and 30 days after treatment with arsenic/IFN/zidovudine, in comparison with HTLV-I healthy carriers and sero-negative blood donors. ATL patients at diagnosis displayed a T(reg)/Th2 cytokine profile with significantly elevated transcript levels of Foxp3, interleukin-10 (IL-10), and IL-4 and had a reduced Th1 profile evidenced by decreased transcript levels of interferon-γ (IFN-γ) and IL-2. Most patients (15/16) responded, with CD4(+)CD25(+) cells significantly decreasing after therapy, paralleled by decreases in Foxp3 transcript. Importantly, arsenic/IFN/zidovudine therapy sharply diminished IL-10 transcript and serum levels concomittant with decrease in IL-4 and increases in IFN-γ and IL-2 mRNA, whether or not values were adjusted to the percentage of CD4(+)CD25(+) cells. Finally, IL-10 transcript level negatively correlated with clinical response at Day 30. CONCLUSIONS: The observed shift from a T(reg)/Th2 phenotype before treatment toward a Th1 phenotype after treatment with arsenic/IFN/zidovudine may play an important role in restoring an immuno-competent micro-environment, which enhances the eradication of ATL cells and the prevention of opportunistic infections

Hepatitis B Virus DNA is absent in Lebanese blood donors who are positive for both anti-Hbc and anti-Hbs antibodies

Background: A major risk during blood transfusion is the transmission of infectious agents such as Hepatitis B virus (HBV). Screening for anti-HBc antibodies has long been used to test HBV infection and thus, blood safety. However, the development of advanced tools enabling HBV-DNA detection rendered the diagnostic benefit of anti-HBc test uncertain. Objectives: In this study, we aimed to evaluate the relationship between HBV-DNA, anti-HBs, and anti-HBc loads. Methods: Sera of 7200 blood donors were first screened for HBs antigen (HBsAg) and anti-HBc antibody. Samples that were found to be HBsAg-negative but anti-HBc-positive were further tested for anti-HBs and HBV-DNA. Results: Of the 7200 tested samples, 7143 (99.2%) were HBsAg-negative, while the remaining 57 (0.8%) samples were HBsAg-positive. Among the HBsAg-negative samples, 490 (6.8%) were anti-HBc-positive. Of the anti-HBc positive samples, 397 (81%) were anti-HBs-positive, while the remaining 93 (19%) samples were anti-HBs-negative. Interestingly, all of the anti-HBc positive samples, which also were positive for anti-HBs, exhibited negative HBV-DNA results. On the other hand, the anti-HBc positive samples, which were negative for anti-HBs, showed both negative and positive HBV-DNA results. Conclusions: Blood samples which are positive for both anti-HBc and anti-HBs are characterized by negative HBV load.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

First-line treatment of Helicobacter pylori in Lebanon: Comparison of bismuth-containing quadruple therapy versus 14-days sequential therapy

Helicobacter Pylori (H. Pylori) is the most common cause of peptic ulcer disease (PUD) and represents a strong risk factor for gastric cancer. Treatment of H. Pylori is, therefore, a persistent need to avoid serious medical complications. Resistance to antibiotics remains to be the major challenge for H. Pylori eradication. In this study, we determined the prevalence of H. pylori infection and evaluated H. pylori eradication efficacy of bismuth-containing quadruple therapy (Pylera) versus 14-days sequential therapy in treatment naïve-Lebanese patients. 1030 patients, showing symptoms of peptic ulcer (PU) and gastritis, underwent 14C-Urea Breath Test and esophagogastroduodenoscopy to examine H. Pylori infection and gastrointestinal disorders. Among the H. Pylori-positive patients 60 individuals were randomly selected, separated into two groups (each consisting of 30 patients) and treated with either bismuth-containing quadruple therapy or 14-days sequential therapy. We show that of the 1050 patients tested: 46.2% were H. pylori-positive, 55% had gastritis, 46.2% had both gastritis and H. pylori infection, 8.8% had gastritis but no H. pylori infection, 44.9% had neither gastritis nor H. pylori infection. Following the 14-days sequential therapy, the eradication rate was significantly higher than that obtained upon using bismuth-containing quadruple therapy [80% (24/30) versus 50% (15/30), χ2 = 5.93, P = 0.015]. In conclusion, we determined H. pylori and gastritis prevalence among Lebanese PU-patients and showed that 14-days sequential therapy is more efficient than bismuth-containing quadruple therapy in terms of H. Pylori-eradication.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The combination of arsenic, interferon-alpha, and zidovudine restores an "immunocompetent-like" micro-environment in patients with adult T-cell leukemia lymphoma

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