85 research outputs found
Neo-adjuvant chemo/immunotherapy in the treatment of stage III (N2) non-small cell lung cancer: a phase I/II pilot study.
In a previous randomized study, we showed that adjuvant immunotherapy with tumor-infiltrating lymphocytes and recombinant interleukin-2 (rIL-2) significantly improved survival in resected N2-Non Small Cell Lung Cancer (NSCLC) patients. The present study assesses feasibility, safety and potential efficacy of combined neo-adjuvant chemotherapy and immunotherapy with peripheral blood mononuclear cells (PBMC) and rIL-2 in resectable N2-NSCLC patients. Eighty-two consecutive N2-NSCLC patients underwent neo-adjuvant chemotherapy with cisplatin and gemcitabine. Out of the 82 patients, 23 were also subjected to leukapheresis prior to neo-adjuvant chemotherapy while the remaining 59 did not. Collected PBMC were analyzed for viability and phenotype and then stored frozen in liquid nitrogen. Thawed PBMC were infused intravenously, 5 days before surgery. After the infusion, rIL-2 was administered subcutaneously until surgery. Only patients with a partial or complete response to neoadjuvant chemotherapy underwent surgery: 13 patients in the experimental immunotherapy group (A) and 32 in the reference group (B). The two groups were homogeneous for all major prognostic factors. Median leukapheresis yield was 10 billion PBMC, (range 3–24 billions). Two to six billion PBMC were infused. The phenotypic analysis showed that similar proportions of CD4 and CD8 cells were present in leukapheresis products, and thawed PBMC, as well as in T lymphocytes isolated from the removed tumours. No severe adverse effects were observed following immunotherapy. No significant differences in overall survival (OS) and event-free survival (EFS) were seen between the two groups. However, the 5-year OS in group A was almost twice as much compared to group B (59% vs 32%). After adjustment for major prognostic factors, a statistically significant 66% reduction in the hazard of death was seen in patients receiving immunotherapy. The OS benefit was more evident in patients with adenocarcinoma than in those with squamous cell carcinoma. This study supports the favorable toxicity profile and potential efficacy of combining neo-adjuvant chemotherapy and immunotherapy with PBMC and rIL-2 in the treatment of N2-NSCLC patients
Immunotherapy of lung cancer: An update
In Germany lung cancer is the leading cause of cancer-associated death in men. Surgery, chemotherapy and radiation may enhance survival of patients suffering from lung cancer but the enhancement is typically transient and mostly absent with advanced disease; eventually more than 90% of lung cancer patients will die of disease. New approaches to the treatment of lung cancer are urgently needed. Immunotherapy may represent one new approach with low toxicity and high specificity but implementation has been a challenge because of the poor antigenic characterization of these tumors and their ability to escape immune responses. Several different immunotherapeutic treatment strategies have been developed. This review examines the current state of development and recent advances with respect to non-specific immune stimulation, cellular immunotherapy ( specific and non-specific), therapeutic cancer vaccines and gene therapy for lung cancer. The focus is primarily placed on immunotherapeutic cancer treatments that are already in clinical trial or well progressed in preclinical studies. Although there seems to be a promising future for immunotherapy in lung cancer, presently there is not standard immunotherapy available for clinical routine
The turbulent destruction of clouds - I. A k-epsilon treatment of turbulence in 2D models of adiabatic shock-cloud interactions
The interaction of a shock with a cloud has been extensively studied in the
literature, where the effects of magnetic fields, radiative cooling and thermal
conduction have been considered. However, the formation of fully developed
turbulence has often been prevented by the artificial viscosity inherent in
hydrodynamical simulations, and a uniform post-shock flow has been assumed in
all previous single-cloud studies. In reality, the flow behind the shock is
also likely to be turbulent, with non-uniform density, pressure and velocity
structure created as the shock sweeps over inhomogenities upstream of the
cloud. To address these twin issues we use a sub-grid compressible k-epsilon
turbulence model to estimate the properties of the turbulence generated in
shock-cloud interactions and the resulting increase in the transport
coefficients that the turbulence brings. A detailed comparison with the output
from an inviscid hydrodynamical code puts these new results into context.
We find that cloud destruction in inviscid and k-epsilon models occurs at
roughly the same speed when the post-shock flow is smooth and when the density
contrast between the cloud and inter-cloud medium is less than 100. However,
there are increasing and significant differences as this contrast increases.
Clouds subjected to strong ``buffeting'' by a highly turbulent post-shock
environment are destroyed significantly quicker. Additional calculations with
an inviscid code where the post-shock flow is given random, grid-scale, motions
confirms the more rapid destruction of the cloud.
Our results clearly show that turbulence plays an important role in
shock-cloud interactions, and that environmental turbulence adds a new
dimension to the parameter space which has hitherto been studied (abridged).Comment: 31 pages, 22 figures, accepted for publication in MNRA
Radio emission from Supernova Remnants
The explosion of a supernova releases almost instantaneously about 10^51 ergs
of mechanic energy, changing irreversibly the physical and chemical properties
of large regions in the galaxies. The stellar ejecta, the nebula resulting from
the powerful shock waves, and sometimes a compact stellar remnant, constitute a
supernova remnant (SNR). They can radiate their energy across the whole
electromagnetic spectrum, but the great majority are radio sources. Almost 70
years after the first detection of radio emission coming from a SNR, great
progress has been achieved in the comprehension of their physical
characteristics and evolution. We review the present knowledge of different
aspects of radio remnants, focusing on sources of the Milky Way and the
Magellanic Clouds, where the SNRs can be spatially resolved. We present a brief
overview of theoretical background, analyze morphology and polarization
properties, and review and critical discuss different methods applied to
determine the radio spectrum and distances. The consequences of the interaction
between the SNR shocks and the surrounding medium are examined, including the
question of whether SNRs can trigger the formation of new stars. Cases of
multispectral comparison are presented. A section is devoted to reviewing
recent results of radio SNRs in the Magellanic Clouds, with particular emphasis
on the radio properties of SN 1987A, an ideal laboratory to investigate
dynamical evolution of an SNR in near real time. The review concludes with a
summary of issues on radio SNRs that deserve further study, and analyzing the
prospects for future research with the latest generation radio telescopes.Comment: Revised version. 48 pages, 15 figure
Gas Accretion and Star Formation Rates
Cosmological numerical simulations of galaxy evolution show that accretion of
metal-poor gas from the cosmic web drives the star formation in galaxy disks.
Unfortunately, the observational support for this theoretical prediction is
still indirect, and modeling and analysis are required to identify hints as
actual signs of star-formation feeding from metal-poor gas accretion. Thus, a
meticulous interpretation of the observations is crucial, and this
observational review begins with a simple theoretical description of the
physical process and the key ingredients it involves, including the properties
of the accreted gas and of the star-formation that it induces. A number of
observations pointing out the connection between metal-poor gas accretion and
star-formation are analyzed, specifically, the short gas consumption time-scale
compared to the age of the stellar populations, the fundamental metallicity
relationship, the relationship between disk morphology and gas metallicity, the
existence of metallicity drops in starbursts of star-forming galaxies, the
so-called G dwarf problem, the existence of a minimum metallicity for the
star-forming gas in the local universe, the origin of the alpha-enhanced gas
forming stars in the local universe, the metallicity of the quiescent BCDs, and
the direct measurements of gas accretion onto galaxies. A final section
discusses intrinsic difficulties to obtain direct observational evidence, and
points out alternative observational pathways to further consolidate the
current ideas.Comment: Invited review to appear in Gas Accretion onto Galaxies, Astrophysics
and Space Science Library, eds. A. J. Fox & R. Dav\'e, to be published by
Springe
The bacterial lysate Lantigen B reduces the number of acute episodes in patients with recurrent infections of the respiratory tract: the results of a double blind, placebo controlled, multicenter clinical trial
IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper
Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.info:eu-repo/semantics/publishedVersio
IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper
Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen
Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies
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