Expert review of clinical immunology
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Expert Rev Clin Immunol · Jan 2013
ReviewCurrent status of monoclonal antibody therapy for the treatment of inflammatory bowel disease: an update.
Inflammatory bowel diseases Crohn's disease and ulcerative colitis are complex multifactorial diseases that involve the interaction between innate and adaptive immunity. TNF-α is a potent proinflammatory cytokine with pleiotrophic effects on cells of the innate and adaptive immune system. ⋯ In addition, new biologic therapies that inhibit various elements in the leukocyte infiltration process and others that target proinflammatory cytokines will be addressed. This review will cover key studies examining the use of biologic agents in the treatment of Crohn's disease and ulcerative colitis.
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Candida is one of the most common causes of nosocomial bloodstream infections. Candidemia is not confined to hematological patients, intensive care units or abdominal surgery wards, but it is remarkably frequent in the internal medicine setting. ⋯ Significant improvements in nonculture-based diagnostic methods, such as serological markers, have been made in recent years, and novel diagnostic techniques should be further studied to enable early pre-emptive therapy. Treatment guidelines indicate that echinocandins are at present the best choice for patients who are severely ill or possibly infected with fluconazole-resistant strains.
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Expert Rev Clin Immunol · Feb 2012
ReviewSolanezumab for the treatment of mild-to-moderate Alzheimer's disease.
Solanezumab (LY2062430) is a humanized monoclonal antibody that binds to the central region of β-amyloid, a peptide believed to play a key role in the pathogenesis of Alzheimer's disease (AD). Eli Lilly & Co is developing an intravenous formulation of solanezumab for the treatment of mild-to-moderate AD. ⋯ The drug is currently being investigated in Phase III trials. While there is a strong hope that solanezumab may represent the first effective passive vaccine for AD treatment, skepticism still exists on the ability of the drug to slow the rate of deterioration in patients with fully established disease.
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The options for treatment of sarcoidosis have expanded. In this article, we outline a stepwise approach to treatment. ⋯ While corticosteroids remain the treatment of choice for initial systemic therapy, other agents have been shown to be steroid sparing, and therefore useful for long-term management. In addition, new agents have proved to be useful for patients with refractory disease.
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Expert Rev Clin Immunol · Nov 2011
ReviewThe current understanding of Stevens-Johnson syndrome and toxic epidermal necrolysis.
Stevens-Johnson syndrome has long been considered to resemble erythema multiforme with mucosal involvement, but is now thought to form a single disease entity with toxic epidermal necrolysis. Although Stevens-Johnson syndrome is less severe, etiology, genetic susceptibility and pathomechanism are the same for Stevens-Johnson syndrome/toxic epidermal necrolysis. The condition is mainly caused by drugs, but also by infections and probably other risk factors not yet identified. ⋯ Besides this, supportive management is crucial to improve the patient's state, probably more than specific immunomodulating treatments. Despite all of the therapeutic efforts, mortality is high and increases with disease severity, patients' age and underlying medical conditions. Survivors may suffer from long-term sequelae such as strictures of mucous membranes including severe eye problems.