The role of the immune system in kidney disease

The immune system and the kidneys are closely linked. In health the kidneys contribute to immune homeostasis, while components of the immune system mediate many acute forms of renal disease and play a central role in progression of chronic kidney disease. A dysregulated immune system can have either direct or indirect renal effects. Direct immune-mediated kidney diseases are usually a consequence of autoantibodies directed against a constituent renal antigen, such as collagen IV in anti-glomerular basement membrane disease. Indirect immune-mediated renal disease often follows systemic autoimmunity with immune complex formation, but can also be due to uncontrolled activation of the complement pathways. Though the range of mechanisms of immune dysregulation leading to renal disease is broad, the pathways leading to injury are similar. Loss of immune homeostasis in renal disease results in perpetual immune cell recruitment and worsening damage to the kidney. Uncoordinated attempts at tissue repair, after immune-mediated disease or non-immune mediated injury, result in fibrosis of structures important for renal function, eventually leading to kidney failure. As renal disease often only manifests clinically when substantial damage has already occurred, new diagnostic methods and indeed treatments must be identified to inhibit further progression and promote appropriate tissue repair. Studying cases in which immune homeostasis is re-established may reveal new treatment possibilities

Rechnungslegung von spendensammelnden Organisationen

Julia TecklenborgAlpen-Adria-Universität Klagenfurt, Masterarbeit, 2015(VLID)241196

Rechnungslegung von spendensammelnden Organisationen

Julia TecklenborgAlpen-Adria-Universität Klagenfurt, Masterarbeit, 2015(VLID)241196

PANTON-VALENTINE LEUKOCIDIN-POSITIVE STAPHYLOCOCCUS AUREUS IN IRELAND 2002-2011: TWENTY-ONE CLONES, FREQUENT IMPORTATION OF CLONES, TEMPORAL SHIFTS OF PREDOMINANT METHICILLIN-RESISTANT S. AUREUS AND INCREASING MULTIRESISTANCE

There has been a worldwide increase in community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) infections. CA-MRSA isolates commonly produce the Panton-Valentine leukocidin toxin encoded by the pvl genes lukF/S-PV. This study investigated the clinical and molecular epidemiology of pvl-positive MRSA and methicillin-susceptible S. aureus (MSSA) identified by the Irish National MRSA Reference Laboratory (NMRSARL) between 2002 and 2011. All pvl-positive MRSA (n = 190) and MSSA (n = 39) isolates underwent antibiogram-resistogram typing, spa typing and DNA microarray profiling for multilocus sequence type, clonal complex (CC) and/or sequence type (ST) and staphylococcal cassette chromosome mec type assignment and virulence and resistance gene detection. Where available, The prevalence of pvl-positive MRSA increased from 0.2%-8.8% and pvl-positive MSSA decreased from 20%-2.5% during the study period. The pvl-positive MRSA and MSSA belonged to 16 and five genotypes, respectively, with CC/ST8-MRSA-IV, CC/ST30-MRSA-IV, CC/ST80-MRSA-IV and CC1/ST772-MRSA-V and CC30-MSSA, CC22-MSSA and CC121-MSSA predominating. Temporal shifts in the predominant pvl-positive MRSA genotypes and a six-fold increase in multiresistant pvl-positive MRSA occurred during the study period. Analysis of patient data indicated that pvl-positive S. aureus strains, especially MRSA, were imported into Ireland several times. Two hospital and six family clusters of pvl-positive MRSA were identified and 70% of patient isolates for which information was available were from patients in the community. This study highlights the increased burden and changing molecular epidemiology of pvl-positive S. aureus in Ireland over the last decade and the contribution of international travel to the influx of genetically diverse pvl-positive S. aureus into Ireland

Exploring the barriers and enablers experienced by people with Cystic Fibrosis and their healthcare professionals in accessing, utilising and delivering maternity and Cystic Fibrosis care during the pre-conception to post-partum period: A mixed methods systematic review protocol. [version 2; peer review: 2 approved]

Background Cystic Fibrosis (CF) is an autosomal recessive inherited multi-system disease that primarily affects the lungs and digestive system. New drug therapies and treatments are improving the lives of many people with CF. With improved life expectancy and increased quality of life, many people with CF are now contemplating parenthood and becoming pregnant, an aspiration that decades ago was almost unheard of. Given this quickly evolving and more positive health landscape, it is vital to understand how people with CF experience the care they receive whilst accessing and utilising fertility and maternity services. It is also important to explore the experiences of healthcare professionals involved in providing care during this period. The overall aim of the mixed-methods systematic review will be to explore the barriers and enablers experienced by people with CF and the healthcare professionals involved in their care in the pre-conception to post-partum period. Methods The proposed review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for convergent integrated mixed methods systematic reviews. A systematic search of Medline (Ebsco), Cinahl, Embase, APA PsychINFO and Cochrane Library from inception to February 2022 will be conducted. Quantitative, qualitative and mixed methods studies pertaining to the experience of pre-conception to post-partum care for people with CF and their healthcare professionals will be included. Two independent reviewers will screen titles, abstracts and full texts with disagreements being resolved by a third reviewer. Conclusion This review will help to determine the potential barriers and facilitators experienced by people with Cystic Fibrosis and the health care professionals involved in their care during the pre-conception to post-partum period. The results will be of benefit specifically to the CF population and their healthcare providers when planning further studies in the area of fertility and pregnancy for this population and when delivering care