Infections with Bartonella henselae or Bartonella quintana present with vasoproliferative lesions in skin and parenchymatous organs in immunocompromised patients. A case report of a 38-year-old patient with HIV infection and hepatitis B surface antigen status is described. The dominant clinical symptoms in our patient were fever and icterus. Ultrasonography of the abdomen showed a picture similar to that of liver cirrhosis. Irregular (echorich) nodes with hyper-vascularization were suspected to be hepatocellular carcinoma. Ultrasound guided puncture of one of these lesions and histological examination revealed the diagnosis of bartonella infection. Under antibiotic treatment with clarithromycin and doxycycline the fever and the hyperbilirubinemia decreased. The sonographically detectable lesions reduced in size. Vasoproliferative lesions in immunodeficient patients caused by bartonella infection show a characteristic slightly hyperechogenic irregular pattern at ultrasound. Typically, circumscribed hypervascularization might be shown by color Doppler imaging. Liver cirrhosis and diffuse tumor infiltration should be excluded.
A fragment of the cloned gene for the human myeloma ND epsilon chain, coding for the second, third, and fourth domains of the immunoglobulin, has been coupled to the tryptophan control region of an expression plasmid and subcloned in Escherichia coli. Induction of gene expression results in the synthesis of the expected, antigenically active polypeptide of Mr 40,000, which constitutes 18% of total bacterial protein and yields 55 mg/liter of culture. The immunoglobulin, which is aggregated and packed into large inclusion bodies within the bacterial cell, can be dissolved by denaturing solvents and purified by affinity chromatography using anti-IgE Sepharose. Reduced monomeric chains assemble spontaneously into dimers. On assay to measure the inhibition of binding of 125I-labeled human E myeloma protein to Fc epsilon receptors on cultured human basophils, the cloned gene product exhibited 20% of the activity of the native protein.
Allergic manifestations affect 20% - 30% of the population in industrialized countries. The global market for asthma and allergy medications has been estimated to exceed USD 6 billion, since 40% of the human population has some form of IgE sensitization to diverse proteins. Most therapeutic intervention strategies cope with the symptoms of allergy without eliminating the underlying cause and many are associated with undesirable and often long-term debilitating side effects. We designed a peptide immunogen encompassing sequences of the human Cε2-3 linker region to prime rat (Rattus norvegicus) immune systems, we then designed a chimeric human-dog-human IgE antibody and used it to boost the immune system and produce high-affinity antibodies that targets native IgE. The investigation showed that this peptide immunogen elicit the formation of antibodies recognizing the native IgE of human, canine and equine origin. The current investigation describes novel approaches aimed at the development of safe anti-allergy vaccines based on active immunization with IgE-derived peptides that are involved in the complementary interaction with the high affinity receptor. The immunization strategy was successful but did not fully work as predicted, thus we propose that peptides described in the current study may lead to the development of a pananti-allergy vaccine with applications for the treatment of all IgE-mediated allergic response independent of the nature of the offending allergen.
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