Cryptococcosis-IRIS is associated with lower cryptococcus-specific IFN-gamma responses before antiretroviral therapy but not higher T-cell responses during therapy
AuthorsChang, Christina C.
Levitz, Stuart M.
Gosnell, Bernadett I.
Elliott, Julian H.
Carr, William H.
Moosa, Mohamed-Yunus S.
Lewin, Sharon R.
French, Martyn A.
UMass Chan AffiliationsDepartment of Medicine, Division of Infectious Diseases and Immunology
Document TypeJournal Article
KeywordsAIDS-Related Opportunistic Infections
Antiretroviral Therapy, Highly Active
Immune Reconstitution Inflammatory Syndrome
Proportional Hazards Models
Immune System Diseases
Immunology of Infectious Disease
Immunoprophylaxis and Therapy
MetadataShow full item record
AbstractBACKGROUND: Cryptococcosis-associated immune reconstitution inflammatory syndrome (C-IRIS) may be driven by aberrant T-cell responses against cryptococci. We investigated this in human immunodeficiency virus (HIV)-infected patients with treated cryptococcal meningitis (CM) commencing combination antiretroviral therapy (cART). METHODS: Mitogen- and cryptococcal mannoprotein (CMP)-activated (CD25+CD134+) CD4+ T cells and -induced production of interferon-gamma (IFN-gamma), IL-10, and CXCL10 were assessed in whole blood cultures in a prospective study of 106 HIV-CM coinfected patients. RESULTS: Patients with paradoxical C-IRIS (n = 27), compared with patients with no neurological deterioration (no ND; n = 63), had lower CMP-induced IFN-gamma production in 24-hour cultures pre-cART and 4 weeks post-cART (P = .0437 and .0257, respectively) and lower CMP-activated CD4+ T-cell counts pre-cART (P = .0178). Patients surviving to 24 weeks had higher proportions of mitogen-activated CD4+ T cells and higher CMP-induced CXCL10 and IL-10 production in 24-hour cultures pre-cART than patients not surviving (P = .0053, .0436 and .0319, respectively). C-IRIS was not associated with higher CMP-specific T-cell responses before or during cART. CONCLUSION: Greater preservation of T-cell function and higher CMP-induced IL-10 and CXCL10 production before cART are associated with improved survival while on cART. Lower CMP-induced IFN-gamma production pre-cART, but not higher CMP-specific T-cell responses after cART, were risk factors for C-IRIS.
SourceJ Infect Dis. 2013 Sep;208(6):898-906. doi: 10.1093/infdis/jit271. Epub 2013 Jun 12.Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/30301
Related ResourcesLink to Article in PubMed
Showing items related by title, author, creator and subject.
Creative art therapy for mental illnessChiang, Mathew; Reid-Varley, William Bernard; Fan, Xiaoduo (2019-05-01)Creative art therapy (CAT) for severe mental illness (SMI) represents an extremely heterogenous body of literature that encompasses the use of a large variety of creative mediums (i.e. visual art, music, dance, drama, writing) in the treatment of mental disorders. The present review provides a narrative summary of the findings on the use of CAT for the selected SMI, being: schizophrenia, trauma-related disorders, major depression, and bipolar disorder. A database search of PubMed and the Cochrane Library was conducted related to the use of CAT in the treatment of mental disorders published between January 2008 and March 2019. A total of 9697 citations were identified to match the search criteria and 86 full-texts were reviewed. Although literature suggests CAT to be a potentially low-risk and high benefit intervention to minimize symptoms and maximize functioning in individuals living with SMI, the lack of methodological rigor, and inconsistency in study methods and outcome measures have prevented the advancement of CAT for use in SMI. Although creation of a single CAT regimen for all psychiatric disorders stands neither practical nor advisable, greater standardization of methods would improve evaluation of CAT interventions. Future research should elucidate biological mechanisms underlying CAT methods.
Acupuncture for urinary urgency in women over 50: what is the evidenceO'Dell, Katherine K.; McGee, Sarah M. (2006-03-28)The article reports on the potential of acupuncture as a therapy for treating urinary urgency (UU) or urge urinary incontinence (UUI) in aging women. Although its efficiency has not yet been established, acupuncture as non-pharmacologic treatment for UUI or UU can be considered safe and may decrease symptoms. Other suggested treatment for urinary urgency were compared with acupuncture.
Mindfulness-Based Stress Reduction and Change in Health-Related BehaviorsSalmoirago-Blotcher, Elena; Hunsinger, Matthew; Morgan, Lucas; Fischer, Daniel; Carmody, James F. (2013-01-01)How best to support change in health-related behaviors is an important public health challenge. The role of mindfulness training in this process has received limited attention. We sought to explore whether mindfulness training is associated with changes in health-related behaviors. The Health Behaviors Questionnaire was used to obtain self-reported dietary behaviors, drinking, smoking, physical activity and sleep quality before and after attendance at an eight-week Mindfulness-Based Stress Reduction program. T-test for paired data and chi-square were used to compare pre-post intervention means and proportions of relevant variables with p = .05 as level of significance. Participants (n = 174; mean age 47 years, range: 19-68; 61 % female) reported significant improvements in dietary behaviors and sleep quality. Partial changes were seen in drinking and physical activity, and no change in smoking. In conclusion, mindfulness training promotes favorable changes in selected health-related behaviors deserving further study through randomized controlled trials.