Immune System Diseases Commons^™

Adherence To Hiv Antiretroviral Therapy Among Pregnant And Postpartum Women During The Option B+ Era: 12-Month Cohort Study In Urban South Africa And Rural Uganda, Lynn T. Matthews, Catherine Orrell, Mwebesa B. Bwana, Alexander C. Tsai, Christina A. Psaros, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Kathleen Bell, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: We conducted a cohort study to understand patterns of anti-retroviral therapy (ART) adherence during pregnancy, postpartum and non-pregnancy follow-up among women initiating ART in public clinics offering Option B+ in rural Uganda and urban South Africa. Methods: We collected survey data, continuously monitored ART adherence (Wisepill), HIV-RNA and pregnancy tests at zero, six and twelve months from women initiating ART in Uganda and South Africa, 2015 to 2017. The primary predictor of interest was follow-up time categorized as pregnant (pregnancy diagnosis to pregnancy end), postpartum (pregnancy end to study exit) or non-pregnancy-related (neither pregnant nor postpartum). Fractional regression …

Cancer-Targeting Immunostimulatory Peptides As An Immunotherapeutic Approach To Cancer, Rachel Montel

Seton Hall University Dissertations and Theses (ETDs)

This dissertation reports the synthesis and biological applications of bifunctional trimeric peptides with B7H6-derived NKp30 binding motifs that serve to activate an immunocytotoxic response in natural killer cells and a GRP78-binding motif that can target tumors that express surface GRP78. In this manner the cancer-targeting immunostimulatory peptides are anticipated to directly bind and activate effector NK92-MI cells while also recognizing and binding to target A549 tumor cells to facilitate NK cell-dependent immunocytotoxicity of the targeted tumors. The NKp30 binding peptide motifs are derived from the tumor associated B7H6 antigen that is often downregulated or shed from the surface of tumors …

Living With Multiple Sclerosis: A Phenomenological Study Of Worries, Concern And Psychological Problems In Iranian Patients With Ms, Zahra Abdekhodaie, Shahriar Shahidi, Mohammad Ali Mazaheri, Laily Panaghi, Vahid Nejati

The Qualitative Report

Multiple sclerosis (MS), as a progressive and degenerative illness, has an impact on different aspects of individual lives and may lead to difficulties, concerns, and worries in patients. The aim of the present study was to investigate concerns, worries and problems in patients with MS. We used a descriptive phenomenological qualitative approach. Participants were volunteers purposively selected based on their availability. We carried out deep interviews with 15 MS patients and analyzed the detailed information obtained from these interviews by using Colaizzi’s method. We extracted six essential themes and thirty-four sub-themes associated with MS from the content of the interviews. …

Insights From Individuals With Chronic Conditions In The Context Of Covid-19, B. Stephen Burton, Jonathan Patterson, Mackenzie Robinson, Dhiren Patel, Matt Allison, Kelly J. Brassil

Patient Experience Journal

The objective of this prospective survey series was to evaluate knowledge and concerns related to the COVID-19 pandemic among individuals with one or more chronic conditions, including cardiometabolic, autoimmune, respiratory and cancer diagnoses. Two surveys were distributed consisting of up to 55 items (March; n=1069) and up to 71 items (April, n=1126), with 24 items repeated from the first survey. Questions focused on healthcare access, barriers and concerns related to the COVID-19 virus. Descriptive analysis evaluated central tendencies, spread, and frequencies of the demographic data, disease states, and survey results within and between the two survey timepoints. Results from 416 …

Modulation Of Inflammatory Pathway By Inflammatory Inhibitor Jsh-23 Mitigates Diabetic Retinopathy., Rubens Petit Homme

Electronic Theses and Dissertations

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM). Its pathology is consisted of the breakdown of the blood-retinal barrier (BRB), particularly the inner blood-retinal barrier (iBRB). The exact mechanism that leads to the iBRB impairment and the development of DR has not been elucidated yet. However, chronic inflammation that is hallmark of the type I DM has recently become a key focus in DR study. Hyperglycemia causes dysregulation of nuclear factor-kappa B (NF-kB); and its constant activation increases the expression of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and intercellular adhesion molecule-1 (ICAM-1) in the …

Development, Expansion And Role Of Myeloid-Derived Suppressor Cells In Post-Sepsis Immune Suppression, Tuqa Alkhateeb

Electronic Theses and Dissertations

Myeloid-derived suppressor cells (MDSCs) numbers increase significantly in sepsis and are associated with high mortality rates. These myeloid cell precursors promote immunosuppression, especially in the late (post sepsis) stage. However, the mechanisms that underlie MDSC expansion and programming are not completely understood. To investigate these mechanisms, we used a cecal-ligation and puncture (CLP) mouse model of polymicrobial sepsis that progresses from an early/acute proinflammatory phase to a late/chronic immunosuppressive phase. Previous studies in our laboratory showed that microRNA (miR)-21 and miR-181b elevate levels of the transcription factor nuclear factor 1 (NFI-A) that promotes MDSC expansion. We report here that miR-21 …

Molecular Mechanisms And Epidemiology Of Covid-19 From An Allergist’S Perspective, Koa Hosoki, Abhijit Chakraborty, Sanjiv Sur

Faculty, Staff and Students Publications

The global pandemic caused by the newly described severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused worldwide suffering and death of unimaginable magnitude from coronavirus disease 2019 (COVID-19). The virus is transmitted through aerosol droplets, and causes severe acute respiratory syndrome. SARS-CoV-2 uses the receptor-binding domain of its spike protein S1 to attach to the host angiotensin-converting enzyme 2 receptor in lung and airway cells. Binding requires the help of another host protein, transmembrane protease serine S1 member 2. Several factors likely contribute to the efficient transmission of SARS-CoV-2. The receptor-binding domain of SARS-CoV-2 has a 10- to 20-fold …

The Utility Of Early Warning Score In Adults Presenting With Sepsis In The Emergency Department Of A Low Resource Setting, Emaduddin Siddiqui, Abdul A. Jokhio, Ahmed Raheem, Shahan Waheed, Syed Hashmatullah

Department of Emergency Medicine

Background: Sepsis is a condition with high mortality and morbidity. Delay in early recognition and prompt management results in higher mortality. There are many clinical scores to identify early sepsis; however, Early Warning Score (EWS) has clinical/physiological parameters that are easy to apply in the ED for timely diagnosis and management. In the present study, we collected information regarding the utilization of EWS in timely identifying the sick patients at triage of a tertiary care center.
Methods: This study was a descriptive cross-sectional investigation conducted in the ED of Aga Khan University Hospital in Karachi, the largest metropolitan city in …

Multi-Omics: Differential Expression Of Ifn-Γ Results In Distinctive Mechanistic Features Linking Chronic Inflammation, Gut Dysbiosis, And Autoimmune Diseases, Heekyong R. Bae, Patrick S. C. Leung, Deborah L. Hodge, John M. Fenimore, Seon Min Jeon, Vishal Thovarai, Amiran Dzutsev, Andrew A. Welcher, Michael Boedigheimer, Michael A. Damore, Myung Sook Choi, Richard A. Fravell, Giorgio Trinchieri, M. Eric Gershwin, Howard A. Young

United States Public Health Resources

Low grade, chronic inflammation is a critical risk factor for immunologic dysfunction including autoimmune diseases. However, the multiplicity of complex mechanisms and lack of relevant murine models limit our understanding of the precise role of chronic inflammation. To address these hurdles, we took advantage of multi-omics data and a unique murine model with a low but chronic expression of IFN-γ, generated by replacement of the AU-rich element (ARE) in the 3’ UTR region of IFN-γ mRNA with random nucleotides. Herein, we demonstrate that low but differential expression of IFN-γ in mice by homozygous or heterozygous ARE replacement triggers distinctive gut …

A Case Of Systemic Sclerosis Sine Scleroderma, Adrian Lugo, Andrew Cappiello, Nemer Dabage, Guruswamy Ramamurthy

West Florida Division GME Research Day 2020

• Scleroderma and systemic sclerosis are autoimmune phenomena that can cause progressive and permanent damage to the organs of the human body.
• They can cause fibrosis of various internal organs, including the kidneys, lungs, GI tract, and heart
• Rarely, the only manifestation of systemic sclerosis is severe hypertension with renal failure, a subset known as systemic sclerosis sine scleroderma.

Dynamic Ultrasound Uniquely Reveals Anterior Capsular Tear Communicating With Vastus Intermedius Fibers, Shiv J Patel, Jasvinder A Singh, Max H Epstein, Prathap Jayaram

Faculty, Staff and Students Publications

We present a case of an anterior capsular tear of the right knee in a previously healthy, active individual. The patient was a 31-year-old male seen one month after the onset of throbbing anterior right knee pain, which progressed to sharp suprapatellar pain over the next three months. Both dynamic ultrasound (US) and MRI were obtained. Dynamic US revealed a tear of the anterior capsule of the right knee complicated by a suprapatellar effusion communicating into the vastus intermedius fibers of the quadriceps tendon. However, these findings were not evident on MRI. In addition to discussing this unique pathology, we …

Cancer Pain And The Risks Of Opioid Abuse, Yarelis Diaz

College of Pharmacy Student Research

No abstract provided.

Combined Effects Of Gender Affirmation And Economic Hardship On Vulnerability To Hiv: A Qualitative Analysis Among U.S. Adult Transgender Women., Larissa Jennings Mayo-Wilson, Eric G. Benotsch, Sheila R. Grigsby, Sarah Wagner, Fatmata Timbo, Tonia Poteat, Lauretta Cathers, Ashlee N. Sawyer, Shelby A. Smout, Rick S. Zimmerman

School of Nursing Faculty Publications

Background: Transgender women ("trans women"), particularly African-American and Latina trans women, have disproportionately high prevalence of HIV in the United States (U.S.). In order to decrease gender dysphoria and overcome discrimination, trans women affirm their gender through social and medical transition, often in contexts of economic hardship and sexual risk. This study qualitatively examined how gender-affirming behaviors enhance or diminish vulnerability to HIV in light of structural and economic barriers to gender transition.Methods: We conducted individual interviews with 19 adult trans women in two U.S. cities (Richmond, VA and St. Louis, MO) who reported one or more sexual risk behaviors …

Exploration Of The Complex Relationship Among Multilevel Predictors Of Prep Use Among Men Who Have Sex With Men In The United States, Kristina M. Rodriguez

Dissertations and Theses

Background: Men who have sex with men (MSM) remain the group most heavily affected by HIV in the United States (US), with MSM of color further disproportionately represented. In July 2012, the US Food and Drug Administration (FDA) approved the use of tenofovir disoproxil fumarate plus emtricitabine (TDF-FTC, Truvada) for use as pre-exposure prophylaxis (PrEP) in HIV-negative adults who are at high-risk of HIV infection. Despite its effectiveness, PrEP prescriptions are reaching only a small proportion of those who could benefit from the drug and prescription rates vary both by race and geographic region. The goal of this dissertation was …

Two Cases Of Severe Combined Immunodeficiency Disease With No Known Variants Identified In Genes Associated With Immunodeficiencies, Megan H. Tucker

Research Days

No abstract provided.

What Are The Rhetorical Strategies And Consequences Of Food Labels Regarding Health, Lifestyle, And Ethics Of Consumers With Food-Related Diseases And Allergies?, Delaney Borchers

Master of Arts in Media and Communication Plan II Graduate Projects

In this study, it is investigated on how health, lifestyle and ethical factors of a consumer with a gluten-related disease and allergy influence their understanding and awareness of gluten-free food labels. This study was implemented through an online survey on a Facebook support group with a total of 195 respondents. The results show that consumers do have a strong awareness and understanding of the differences between certified gluten-free and non-certified gluten-free food labels. This indicates that having this strong awareness and understanding is influenced based upon a consumer’s health, lifestyle and ethical factors of following a gluten-free diet.

Gut Pathophysiology In Mouse Models Of Social Behavior Deficits, Kyla Scott

Undergraduate Honors Theses

Autism spectrum disorders (ASD) encompass neurodevelopment disorders characterized by atypical patterns of development that impact multiple areas of functioning beginning in early childhood. The etiology of ASD is unknown and there are currently no preventative treatment options. Gastrointestinal symptoms are commonly associated comorbidities. The microbiota-gut-brain axis is a multidirectional communication chain that connects the central and enteric nervous system that relates brain function to peripheral intestinal functions. Changes within this axis have been postulated in ASD. For example, the “leaky gut theory” proposes that chronic inflammation is linked to alterations in the bacterial profiles of the gut microbiome and subsequent …

Filifactor Alocis: Resilience And Manipulation Against Neutrophil Effector Functions In A Dysbiotic Oral Environment., Max N. Rogers

College of Arts & Sciences Senior Theses

Periodontitis is a multifactorial chronic inflammatory infectious disease that affects around 50% of the adult population in the USA. Neutrophils, which are the primary immune cells recruited to restore health at sites of infection, are profuse in the gingival space during oral infections. In a community-wide effort, pathogenic oral bacteria hijack neutrophil effector functions to evade killing, resulting in an uncontrollable inflammatory loop that leads into inflammation-mediated tissue injury. One of these harmful emerging oral pathogens, Filifactor alocis, has been shown to evade neutrophil killing and contribute to disease progression. The purpose of this study is to gain a …

“A Moral Imperative To Prevent Aids”: Race And Religion In Atlanta’S Aids Activism, 1981-1993, Madison Bailey

Honors Theses

The early years of the AIDS epidemic marked a tumultuous period of American history, calling into question the authority of doctors and the ability of scientists to cure disease. Already marginalized groups, such as gay men and intravenous drug users, appeared to be most vulnerable to a deadly virus with no cure or effective treatments. In the face of discrimination, activists rose up to provide necessary services for AIDS patients and advocate on their behalf. This activism uniquely characterized the early AIDS epidemic and permanently changed the field of biomedical research. The current historiography of AIDS activism tends to focus …

Investigating The Interactions Between Individual Calmodulin And Hiv-1 Protein Domains, Riley K. Kendall, Jerry Larue

Student Scholar Symposium Abstracts and Posters

The World Health Organization found that 37.9 million people were living with HIV by the end of 2018. HIV is a virus that weakens the immune system through viral replication and the destruction of CD4⁺ T-cells, which are white blood cells that detect infection and make antibodies. A cure for HIV has not yet been discovered. HIV-1 contains a Gag polyprotein which regulates the stages of viral replication. Previous studies suggest that the myristoyl group of a matrix protein peptide found on the Gag polyprotein, MA, forms a complex with a calcium-binding, multifunctional regulatory protein called Calmodulin (CaM). CaM …

Targeting Natural Killer Cells For Improved Immunity And Control Of The Adaptive Immune Response., Stephen Pierce, Eric S. Geanes, Todd Bradley

Manuscripts, Articles, Book Chapters and Other Papers

Natural killer (NK) cells are critical for targeting and killing tumor, virus-infected and stressed cells as a member of the innate immune system. Recently, NK cells have also emerged as key regulators of adaptive immunity and have become a prominent therapeutic target for cancer immunotherapy and infection control. NK cells display a diverse array of phenotypes and function. Determining how NK cells develop and are regulated is critical for understanding their role in both innate and adaptive immunity. In this review we discuss current research approaches into NK cell adaptive immunity and how these cells are being harnessed for improving …

Heterogeneous Nuclear Ribonucleoprotein K (Hnrnp K) Overexpression And Its Interaction With Runx1 Rna In Acute Myeloid Leukemia, Marisa Aitken

Dissertations and Theses (Open Access)

Acute myeloid leukemia (AML) is an often devastating hematologic malignancy with 5-year overall survival lingering near 20%. Acquiring a deeper understanding of molecular underpinnings of leukemogenesis will provide a basis for developing more effective therapeutic strategies for patients with AML.

Here, we identified overexpression of hnRNP K as a recurrent abnormality in a subset (~20%) of AML patients. High levels of this RNA-binding protein associated with inferior clinical outcomes in de novo AML. Thus, to evaluate its putative oncogenic capacity in myeloid disease, we overexpressed hnRNP K in murine hematopoietic stem and progenitor cells isolated from fetal liver cells (FLCs). …

Unique Case Of Anca-Negative Pauci-Immune Necrotizing Glomerulonephritis With Diffuse Alveolar Hemorrhage, Potentially Associated With Midostaurin, Jonathan D Pankow, Guillaume Richard-Carpentier, Naval G Daver, William F Glass, Jaya Kala

Faculty, Staff and Student Publications

We present a 61-year-old male with FLT3-mutated acute myeloid leukemia treated with midostaurin who developed acute kidney injury requiring hemodialysis and pulmonary renal syndrome. Antibodies to proteinase-3, myeloperoxidase, and glomerular basement membrane were negative. Renal biopsy confirmed acute pauci-immune focal necrotizing glomerulonephritis (GN) with fibrin crescents indicating rapidly progressing glomerulonephritis. He improved with pulse methylprednisolone, intravenous cyclophosphamide, and plasma exchange with resolution of hemoptysis. This case highlights the importance of prompt renal biopsy to guide early initiation of life-saving therapies. To our knowledge, this is the first reported case of ANCA-negative pauci-immune necrotizing GN likely secondary to midostaurin.

The Role Of Nutrition In Promoting Gut Health And Treating Chronic Illness Through The Attenuation Of Inflammation, Allison Dalton

HCA Healthcare Journal of Medicine

Over the millennia, the human body and microorganisms such as bacteria, viruses, archaea, protozoa and parasites have coevolved together forming an intimate relationship. These microorganisms are found on the skin, in the mouth, genitourinary tract and most abundantly in the large intestine of the digestive tract. States of microbial dysbiosis contribute to chronic inflammation, which can lead to the pathogenesis and progression of numerous diseases. Micro- and macro-nutrients as well as dietary patterns like the Mediterranean diet can help improve health outcomes.

Vaccines In Current Culture: The Hpv Vaccine Controversy, Alyssa Johnston

Senior Honors Theses

The use of vaccinations has drastically decreased mortality and morbidity rates related to infectious disease and has become an intrinsic part of modern health care. However, the fear of risks related to vaccines has been partially responsible for the decisions of many parents to delay or avoid vaccinating their children. The human papilloma virus (HPV) vaccine specifically is one of the most controversial vaccines in current culture due to reports of new onset or exacerbation of autoimmune diseases, infertility, and even death following its administration. This review synthesizes information regarding the relevance and safety of the HPV vaccine, as well …

Post-Surgical Pyoderma Gangrenosum After Breast Surgery: A Case Series, Jahan Tajran, Daniella Anderson, Arif Chaudhry, Dennis Hammond

Medical Student Research Symposium

Background:

Pyoderma gangrenosum (PG) is a rare inflammatory cutaneous disorder that is thought to be due to innate immune system dysfunction, specifically of neutrophils. PG has been well documented in patients with autoimmune disorders like Ulcerative Colitis and Rheumatoid Arthritis. PG can also present in surgical patients, imitating a potential wound infection and necrotizing fasciitis. Although PG is a diagnosis of exclusion, prompt recognition is essential to attaining desired aesthetic outcomes, especially with breast involvement. We present a case series of four patients who developed PG following breast surgery. We analyze each patient’s medical history, symptoms, wound progression and management …

The Great Imitator Strikes Again: A Case Of A Lupus Flare-Up Presenting Like An Acute Abdomen, Emmanouil Kiriakopoulos, Vanessa Perez, Robyn Hoelle

HCA Healthcare Journal of Medicine

Systemic lupus erythematosus (SLE) is an autoimmune disease affecting all age groups and can manifest in various forms, often making the initial or successive presentations difficult to diagnose. Peritonitis secondary to lupus is a rare manifestation of this disease and the prevalence is said to be much lower in children. We present a case report of an adolescent male with a known history of lupus who presented to the emergency department with a clinical picture consistent with an acute surgical abdomen and underwent an appendectomy. Subsequent workup identified the culprit as a lupus-related peritonitis requiring corticosteroids for resolution.

Evidence To Support Hiv Prevention For Adolescent Girls And Young Women (Agyw) And Their Male Partners: Results From Malawi Dreams Studies With Agyw, Male Partners Of Agyw, Men Living With Hiv, And Program Implementing Partners, Nanlesta Pilgrim, Victor Mwapasa, Effie Chipeta, Wanangwa Chimwaza Manda, Nrupa Jani, Tracy Mcclair, Lyson Tenthani, Sanyukta Mathur

HIV and AIDS

Project SOAR, led by the Population Council, in partnership with the Center of Reproductive Health at the University of Malawi College of Medicine, conducted a research portfolio to generate evidence to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. The objectives of this implementation research were to generate evidence for describing HIV-related risk factors among AGYW; assess the extent to which the overall DREAMS project contributed toward the goal of reducing HIV risk among AGYW; and understand the characteristics of male partners and how to link them to HIV services, as well as retain …

Community-Based Hiv Treatment Service Delivery Model For Female Sex Workers In Tanzania: Evaluation Findings, Lung Vu, Waimar Tun, Louis Apicella, Jeremiah Kidola, Caterina Casalini, Gasper Mbita, Neema Makyao, Todd Koppenhaver, Erick Mlanga

HIV and AIDS

Project SOAR in collaboration with the National AIDS Control Program of the Government of Tanzania, National Institute of Medical Research, and Jhpiego’s Sauti Program, conducted an implementation science study to investigate the delivery of community-based antiretroviral treatment (ART) services to female sex workers (FSWs) in Tanzania. Studies from sub-Saharan Africa have shown improved HIV treatment outcomes, such as uptake of HIV services, retention in care, and increased dignity and quality of life, by using community-based delivery of HIV services. As detailed in this Project SOAR final report, the study assessed the effectiveness of the community-based ART delivery intervention in improving …

Strengthening Capacity For Assessment Of Hiv-Related Data Needs Among Key Populations To Inform Evidence-Based Responses, Amrita Rao, Nikita Viswasam, Stefan Baral

HIV and AIDS

Defining the HIV prevention and treatment needs of key populations who have disproportionate HIV acquisition and transmission risks has been particularly difficult in the context of generalized HIV epidemics where less attention has historically been placed on the HIV prevention and treatment needs of these groups. There is a gap in our understanding of the specific needs of—and ultimately the investment case for the added value of supporting—disproportionately burdened key populations in these settings. In response to this gap, Johns Hopkins University under the United States Agency for International Development (USAID)-funded Project SOAR implemented a project in partnership with collaborators, …