The Experts below are selected from a list of 1713 Experts worldwide ranked by ideXlab platform
Michael E. Wechsler - One of the best experts on this subject based on the ideXlab platform.
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Mepolizumab or Placebo for Eosinophilic Granulomatosis with Polyangiitis
The New England journal of medicine, 2017Co-Authors: Michael E. Wechsler, Praveen Akuthota, David Jayne, Paneez Khoury, Amy D. Klion, Carol A. Langford, Peter A. Merkel, Frank Moosig, Ulrich Specks, Maria C. CidAbstract:BackgroundEosinophilic granulomatosis with polyangiitis is an Eosinophilic Vasculitis. Mepolizumab, an anti–interleukin-5 monoclonal antibody, reduces blood eosinophil counts and may have value in the treatment of Eosinophilic granulomatosis with polyangiitis. MethodsIn this multicenter, double-blind, parallel-group, phase 3 trial, we randomly assigned participants with relapsing or refractory Eosinophilic granulomatosis with polyangiitis who had received treatment for at least 4 weeks and were taking a stable prednisolone or prednisone dose to receive 300 mg of mepolizumab or placebo, administered subcutaneously every 4 weeks, plus standard care, for 52 weeks. The two primary end points were the accrued weeks of remission over a 52-week period, according to categorical quantification, and the proportion of participants in remission at both week 36 and week 48. Secondary end points included the time to first relapse and the average daily glucocorticoid dose (during weeks 48 through 52). The annualized rel...
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mepolizumab as a steroid sparing treatment option in patients with churg strauss syndrome
The Journal of Allergy and Clinical Immunology, 2010Co-Authors: Gautham Marigowda, Eyal Oren, Elliot Israel, Michael E. WechslerAbstract:Background Treatments for Churg-Strauss syndrome (CSS), a rare Eosinophilic Vasculitis characterized by asthma, sinusitis, peripheral eosinophilia, pulmonary infiltrates, and tissue infiltration, are limited by toxicity or poor efficacy. Levels of IL-5, a cytokine regulating eosinophils, can be increased in patients with CSS. Mepolizumab, a humanized monoclonal anti–IL-5 antibody, decreases steroid requirements in patients with non-CSS hyperEosinophilic syndromes. Objective The purpose of this study was to assess whether mepolizumab would safely allow corticosteroid tapering in patients with steroid-dependent CSS while decreasing serum markers of disease activity. Methods This open-label pilot study treated 7 patients with 4 monthly doses of mepolizumab to assess whether it safely decreased CSS disease activity and permitted tapering of systemic corticosteroids. Results Mepolizumab was safe and well tolerated in patients with CSS. Mepolizumab reduced eosinophil counts and allowed for safe corticosteroid reduction in all 7 subjects. On cessation of mepolizumab, CSS manifestations recurred, necessitating corticosteroid bursts. Conclusion Mepolizumab is a safe and well-tolerated therapy in patients with CSS, offering clinical benefit by enabling corticosteroid tapering while maintaining clinical stability.
Christina Strube - One of the best experts on this subject based on the ideXlab platform.
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Histopathological characterization of Toxocara canis- and T. cati-induced neurotoxocarosis in the mouse model
Parasitology Research, 2019Co-Authors: Andrea Springer, Lea Heuer, Elisabeth Janecek-erfurth, Andreas Beineke, Christina StrubeAbstract:Infective larvae of Toxocara canis and T. cati , the common roundworms of dogs and cats, may invade the central nervous system of paratenic hosts, including humans, causing neurotoxocarosis (NT). Previous studies on NT in the model organism “mouse” have indicated distinct differences between T. canis and T. cati regarding larval migration patterns as well as the severity of clinical symptoms and behavioural alterations. The objective of the present study was to provide an extensive characterization of the underlying histopathological alterations, comparing T. canis - and T. cati -induced changes in different brain areas over the course of murine infection. Four histological sections of five brains each of T. canis - and T. cati -infected as well as uninfected C57Bl/6 mice were investigated 7, 14, 28, 42, 70 and 98 days post infection (dpi), while brains of T. cati -infected and control mice were also available 120 and 150 dpi. In addition to haematoxylin-eosin and luxol fast blue-cresyl violet staining, immunohistochemistry was employed to study microglia/macrophage cell morphology and to detect accumulation of β-amyloid precursor protein (β-APP) as an indicator of axonal damage. Haemorrhages, Eosinophilic Vasculitis and activated microglia/macrophages were detected in both infection groups starting 7 dpi, followed by Eosinophilic meningitis in cerebra as from 14 dpi. Overall, little differences in the proportion of animals affected by these alterations were found between the two infection groups. In contrast, the proportion of animals displaying β-APP accumulation was significantly higher in the T. canis than T. cati group as from 28 dpi regarding the cerebrum as well as at 98 dpi regarding the cerebellum. In T. canis -infected mice, myelinophagic microglia/macrophages (“gitter cells”) appeared as from 14 dpi, whereas these were first observed at 70 dpi in T. cati -infected animals. The proportion of animals displaying demyelination and/or gitter cells in the cerebrum was significantly higher in the T. canis than T. cati group as from 28 dpi, and at 28 and 42 dpi regarding the cerebellum. Earlier and more severe neurodegeneration during T. canis - than T. cati -induced NT, especially in the cerebrum, may explain the differences in behavioural alterations observed in previous studies. In addition to differences in larval migration preferences, immunological processes may contribute to these patterns, which warrant further investigation.
E Hachulla - One of the best experts on this subject based on the ideXlab platform.
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idiopathic Eosinophilic Vasculitis another side of hyperEosinophilic syndrome a comprehensive analysis of 117 cases in asthma free patients
The Journal of Allergy and Clinical Immunology: In Practice, 2020Co-Authors: Guillaume Lefevre, Amelie Leurs, Jeanbaptiste Gibier, Mariechristine Copin, D Staumontsalle, F Dezoteux, Cecile Chenivesse, Benjamin Lopez, Louis Terriou, E HachullaAbstract:Background The absence of asthma may rule out a diagnosis of Eosinophilic granulomatosis with polyangiitis in patients with hyperEosinophilic syndrome (HES) and features of Vasculitis. Objective To describe Eosinophilic Vasculitis (EoV) as a possible manifestation of HES in asthma-free patients. Methods We screened our hospital database and the literature for patients with HES who met the following 4 criteria: (1) histopathological or clinical features of EoV (biopsy-proven Vasculitis with predominant Eosinophilic infiltration of the vessel wall and/or features of Vasculitis with tissue and/or blood hypereosinophilia [absolute eosinophil count >1.5 G/L]); (2) no other obvious causes of reactive eosinophilia, organ damage, and Vasculitis; (3) the absence of antineutrophil cytoplasmic antibodies; and (4) the absence of current asthma. Results Ten of our 83 (12%) asthma-free patients with HES and 107 additional cases in the literature met the criteria for EoV. After a critical analysis of the patients' clinical and laboratory characteristics and outcomes, we identified 41 cases of single-organ EoV (coronary arteritis, n = 29; temporal arteritis, n = 8; cerebral Vasculitis, n = 4). Of the remaining 76 patients with EoV, the most frequent manifestations (>10%) were cutaneous Vasculitis (56%), peripheral neuropathy (24%), thromboangiitis obliterans–like disease (16%), fever (13%), central nervous system involvement (13%), deep venous thrombosis (12%), and nonasthma lung manifestations (12%). Blood hypereosinophilia more than 1.5 G/L was observed in 79% of patients, and necrotizing Vasculitis was observed in 44%. Conclusions Our results suggest that idiopathic EoV (HES-associated Vasculitis) can be classified as an Eosinophilic-rich, necrotizing, systemic form of Vasculitis that affects vessels of various sizes in asthma-free patients.
Andrea Springer - One of the best experts on this subject based on the ideXlab platform.
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Histopathological characterization of Toxocara canis- and T. cati-induced neurotoxocarosis in the mouse model
Parasitology Research, 2019Co-Authors: Andrea Springer, Lea Heuer, Elisabeth Janecek-erfurth, Andreas Beineke, Christina StrubeAbstract:Infective larvae of Toxocara canis and T. cati , the common roundworms of dogs and cats, may invade the central nervous system of paratenic hosts, including humans, causing neurotoxocarosis (NT). Previous studies on NT in the model organism “mouse” have indicated distinct differences between T. canis and T. cati regarding larval migration patterns as well as the severity of clinical symptoms and behavioural alterations. The objective of the present study was to provide an extensive characterization of the underlying histopathological alterations, comparing T. canis - and T. cati -induced changes in different brain areas over the course of murine infection. Four histological sections of five brains each of T. canis - and T. cati -infected as well as uninfected C57Bl/6 mice were investigated 7, 14, 28, 42, 70 and 98 days post infection (dpi), while brains of T. cati -infected and control mice were also available 120 and 150 dpi. In addition to haematoxylin-eosin and luxol fast blue-cresyl violet staining, immunohistochemistry was employed to study microglia/macrophage cell morphology and to detect accumulation of β-amyloid precursor protein (β-APP) as an indicator of axonal damage. Haemorrhages, Eosinophilic Vasculitis and activated microglia/macrophages were detected in both infection groups starting 7 dpi, followed by Eosinophilic meningitis in cerebra as from 14 dpi. Overall, little differences in the proportion of animals affected by these alterations were found between the two infection groups. In contrast, the proportion of animals displaying β-APP accumulation was significantly higher in the T. canis than T. cati group as from 28 dpi regarding the cerebrum as well as at 98 dpi regarding the cerebellum. In T. canis -infected mice, myelinophagic microglia/macrophages (“gitter cells”) appeared as from 14 dpi, whereas these were first observed at 70 dpi in T. cati -infected animals. The proportion of animals displaying demyelination and/or gitter cells in the cerebrum was significantly higher in the T. canis than T. cati group as from 28 dpi, and at 28 and 42 dpi regarding the cerebellum. Earlier and more severe neurodegeneration during T. canis - than T. cati -induced NT, especially in the cerebrum, may explain the differences in behavioural alterations observed in previous studies. In addition to differences in larval migration preferences, immunological processes may contribute to these patterns, which warrant further investigation.
Kunihiko Tamaki - One of the best experts on this subject based on the ideXlab platform.
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recurrent cutaneous Eosinophilic Vasculitis presenting as annular urticarial plaques
Acta Dermato-venereologica, 2005Co-Authors: Yuichiro Tsunemi, Hidehisa Saeki, Hironobu Ihn, Kunihiko TamakiAbstract:Sir, Clinical and histological cutaneous necrotizing Vasculitis of dermal small vessels with an almost exclusively Eosinophilic infiltration and without any features of the systemic disease has recently been described by Chen et al. as recurrent cutaneous Eosinophilic Vasculitis (RCEV) (1, 2). This disease is rare and only a few cases have been reported (1–4). We here describe one more case of RCEV presenting as annular urticarial plaques.