To study the long term effects of monthly intravenous cyclophosphamide therapy in Wegener's granulomatosis.
Fourteen consecutive patients with active Wegener's granulomatos treated with a first-line ...combination of high-dose prednisone and monthly intravenous pulse cyclophosphamide were retrospectively studied.
One patient died from septicemia complicating severe leukopenia after the first pulse. At 8 months after instituting intravenous pulse cyclophosphamide therapy, failure was observed in 6 other patients. Between month 16 and 18, 2 other patients relapsed when the time between 2 pulses was lengthened. Five patients developed cyclophosphamide-related side-effects: infection (n = 2), amenorrhea (n = 1), alopecia (n = 2) and vomiting (n = 2). Except for one fatal infection, no major side-effect of intravenous cyclophosphamide therapy was observed. At the end of the study, all patients were off intravenous cyclophosphamide therapy with more than 6 months of followup. The 6 responders were in remission on low-dose prednisone or without treatment.
A combination of high-dose prednisone and intravenous cyclophosphamide may achieve long-term remission in 42% of patients with Wegener's granulomatosis. Responders to intravenous cyclophosphamide therapy had less extensive disease than non-responders.
Gold immunolabeling combined with negative staining (GINS) provides a valuable immunocytochemical approach that allows a direct ultrastructural definition of all viral vaccine constituents that share ...common antigenic features with pathogenic viral particles. These results have implications for the development of viral vaccines since it has been demonstrated that incomplete viral particles such as natural empty capsides and Rotavirus-like particles lacking the infective genome are potential candidates for the production of neutralizing antibodies. Furthermore comparative results of the application of GINS to either inactivated vaccines or unfixed samples provide direct evidence that even after inactivation specific antigenic sites are still available for gold immunolabeling.
L’application combinée de la coloration négative et de l’immunomarquage à l’or colloïdal (GINS, pour ‘gold immunolabeling combined with negative staining’), permet d’identifier à la fois les caractères structuraux et les propriétés antigéniques de plusieurs vaccins à l’aide des anticorps spécifiques. L’application de cette méthode aux vaccins contre les virus de la polio et de l’hépatite A, a mis en évidence la présence de très nombreuses capsides vides dans les préparations vaccinales. Ces structures ont une antigénicité élevée tout à fait comparable à celle des particules virales complètes. De même, l’étude de capsides de rotavirus dépourvues de génome, produites par des systèmes recombinants, montre que ces pseudo-particules virales ont une antigénicité élevée. La méthode décrite est une technique relativement rapide et simple, adaptée aux moyens des laboratoires de pays en voie de développement. Nos résultats peuvent aussi contribuer au choix d’une stratégie dans la production de vaccins, fondée sur l’isolement et la production de particules pseudo-virales, dépourvues de génome, mais hautement antigéniques.
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