Occurrence Of Autoimmune Diseases Research Articles

Integrative Review on Silicone Breast Implants and ASIA Syndrome: What is the relationship?

OBJECTIVE: The study aims to indicate the correlation between breast implants and the occurrence of ASIA Syndrome. METHODOLOGY: The articles were selected from the PubMed database, published between 2016 and 2021. The research used the Health Science Descriptors (DeCS) and their synonyms, in English: breast implants, silicones, autoimmune diseases and rheumatic diseases . RESULTS: Despite the divergent results between the studies analyzed, in most cases the correlation is evident between breast implants and the occurrence of autoimmune diseases. DISCUSSION: ASIA syndrome is involved as an adjuvant factor for the development of autoimmunity, as there is an exacerbation of the immunological response, with the release of cytokines and defense cells in the body with the presence of breast implants. The diagnosis is made based on the patient's symptoms and past history, in which there are characteristic symptoms. The main treatment is the extraction of breast implants. There is an important correlation between low vitamin D levels and ASIA syndrome, in addition to the presence of other autoimmune diseases. CONCLUSION: Breast implants can be an adjuvant for the occurrence of ASIA syndrome, being reaffirmed by the improvement factors after silicone removal.

Association between COVID-19 vaccines and development of chronic morbidities: a cross-sectional study in the Jordanian population

Background In Jordan, individuals recently diagnosed with chronic illnesses have expressed concerns with regard to COVID-19 vaccines. This study aims to investigate potential associations between COVID-19 vaccination and the likelihood of recipients developing chronic conditions such as autoimmune diseases, rheumatoid arthritis, diabetes, asthma, and hypertension. Methodology Through a cross-sectional survey-based descriptive approach, this research was conducted to gather data within the Jordanian context. A web-based survey was utilized to collect demographic information, record vaccine-related side effects, and document the chronic disease status subsequent to COVID-19 vaccination. Statistical analysis was employed to reveal any potential associations between the vaccine, its side effects, and the emergence of chronic morbidities Results The study involved 414 participants, among whom 10.4% exhibited pre-existing chronic diseases before vaccination. Remarkably, post-vaccination, 23.7% of participants were newly diagnosed with chronic illnesses. Statistical analysis indicated a significant correlation between COVID-19 vaccination and the subsequent development of chronic diseases (p-value ˂.01). the investigation found no significant association between vaccination and the emergence of diabetes, hypertension, or asthma (p-value ≥.01) However, an association was found between COVID-19 vaccination and the development of autoimmune diseases and rheumatoid arthritis (p-value ˂.01). Conclusions This study highlights an association between the occurrence of autoimmune diseases and COVID-19 vaccination, while findings related to diabetes, asthma, and hypertension did not display significant associations. The results emphasize the necessity for further research to ascertain potential causal relationship.

Thymic hyperplasia as a rare etiology of pure red cell aplasia: A case report

Introduction. Thymic hyperplasia is a rare condition caused by an increase in cellular thymic mass and, in some cases, is associated with autoimmune diseases, such as pure red cell aplasia (PRCA). Thymectomy is considered the most effective therapy for PRCA associated with thymoma, with a 31.5% complete remission rate. Other treatments may induce partial remissions, but complete remission re-mains elusive. A case of PRCA attributed to thymic hyperplasia is presented, highlighting the effectiveness of thymectomy. Case report. A previously healthy 18-year-old woman presented with severe anemia and after hematological evaluation, including bone marrow biopsy confirmation, a diagnosis of PRCA was made. Immunological and virological analyses were unremarkable. Given the history of thymoma in the family and the known association between thymoma and PRCA, a chest magnetic resonance imaging was performed, which proved the existence of thymic hyperplasia. The patient underwent the least invasive surgical procedure ? total thymectomy using video-assisted thoracic surgery approach. Pathohistological examination of the operative material confirmed the presence of thymic hyperplasia with a simple intrathymic cyst. Following thymectomy, the patient?s hematological values significantly improved. Conclusion. The course and outcome of the patient?s treatment support the role of thymectomy in PRCA associated with thymic hyperplasia. However, further re-search and follow-up are needed to optimize management strategies for this rare condition.

The roles and mechanisms of ETS1 in autoimmune diseases and cancers: A comprehensive review

E26 transformation-specific-1 (ETS1) is a founding member of the ETS transcription factor family. This transcription factor is highly conserved in amino acid sequences and highly expressed in many immune tissues, such as the thymus, spleen, and lymph gland. ETS1 plays multiple regulatory roles in immune-related diseases and acts as a transcriptional activator or inhibitor of many genes to regulate immune cell differentiation, development, apoptosis, and tumor occurrence. The expression level of ETS1 is correlated with disease severity. However, the molecular mechanisms behind disease and tumor progression mediated by ETS1 have not been fully elucidated. In addition, the therapeutic potential of ETS1 in clinical treatment remains to be further explored. Here, we review and summarize the molecular structure and functions of ETS1 and then focus on the roles of ETS1 in the occurrence of autoimmune diseases and cancers. This review provides a reference corroborating ETS1 as a potential therapeutic target for immune-related diseases and cancers.

Antinuclear and Specific Autoantibodies Predict Autoimmune Disease in Sickle Cell Patients: A Longitudinal Cohort Study

Introduction: Sickle cell disease (SCD), the most frequent genetic disorder, can be associated with systemic autoimmune diseases (ADs). High levels of antinuclear antibodies (ANA) are commonly described in SCD, as alloimmunization after blood transfusion. However, the specificity and the prognostic value of ANA have not been fully determined. We aimed to evaluate the association of ANA with AD development during long-term follow-up in SCD patients. Our secondary goal was to assess mortality and serious SCD-related events in this population. Patients and methods: We conducted a single-center longitudinal cohort study on 66 adult SCD patients with ANA titers ≥1/320 at baseline followed over a 13 year-period. Patients known to have an AD (n=9) were excluded from the risk analysis. Results: During follow-up, 13 out of 57 patients (23%) developed AD. Patients with ANA titers ≥1/1280 had a 3-fold increased risk of developing AD (RR 3.4[1.4;8.6]) and a 9-fold increased risk in the presence of specific autoantibodies (anti-DNA, anti-ENA, RF or ACPA) (RR 9.0[3.7;23]) with a positive (PPV) and negative predictive value (NPV) of 90%. When these two immunological features were associated, specificity and PPV reached 100%, with a NPV of 84%. There was no significant difference in the occurrence of serious SCD-related events or mortality rate according to AD. Conclusions: Sickle cell patients with high level of antinuclear antibodies and specific autoantibodies are at high risk of developing AD. The occurrence of AD does not seem to have a significant impact on the course and severity of SCD.

Glyburide-treated human monocyte-derived dendritic cells loaded with insulin represent tolerogenic features with anti-inflammatory responses and modulate autologous T cell responses in vitro

Tolerogenic dendritic cells (TolDCs) are attractive therapeutic options for autoimmune disorders because they suppress autologous T-cell responses. Dendritic cells (DCs) are equipped with pattern recognition receptors (PRR), including nucleotide-binding and oligomerization domain-like receptors (NLRs) such as NLRP3. Abnormal NLRP3 activation has been reported to be correlated with the occurrence of autoimmune disorders. Accordingly, we hypothesized that glyburide treatment of DCs by blocking the ATP-sensitive K+ (kATP) channels generates TolDCs by inhibiting NLRP3. Insulin was even loaded on a group of glyburide-treated mature DCs (mDCs) to investigate the antigen (Ag) loading effects on glyburide-treated mDCs' phenotypical and functional features. Consequently, T lymphocytes' mediated responses ensuing co-culture of them with control mDCs, insulin loaded and unloaded glyburide treated mDCs were evaluated to determine generated TolDCs' capacity in inhibition of T cell responses that are inducer of destruction in insulin-producing pancreatic beta cells in Type 1 Diabetes Mellitus (T1DM). Our findings indicated that glyburide generates desirable TolDCs with decreased surface expression of maturation and Ag presentation related markers and diminished level of inflammatory but increased level of anti-inflammatory cytokines, which even insulin loading demonstrated more anti-inflammatory functions. In addition, co-cultured T cells showed regulatory or T helper 2 phenotype instead of T helper 1 features. Our findings suggested that insulin-loaded and unloaded glyburide-treated DCs are promising therapeutic approaches for autoimmune patients, specifically DCs loaded with insulin for T1DM patients. However, further research is required before this technique can be applied in clinical practice.

The distribution of heterophilic antigens and their relationship with autoimmune diseases.

Microbial infections are associated with the occurrence of autoimmune diseases, but the mechanisms of microbial infection inducing autoimmune diseases are not fully understood. The existence of heterophilic antigens between microorganisms and human tissues may explain part of the pathogenesis of autoimmune diseases. Here, we investigate the distribution of heterophilic antigens and its relationship with autoimmune diseases. Monoclonal antibodies against a variety of microorganisms were prepared. The titer, subclass and reactivity of antibodies with microorganisms were identified, and heterophilic antibodies that cross-reacted with human tissues were screened by human tissue microarray. The reactivity of these heterophilic antibodies with different individuals and different species was further examined by immunohistochemistry. In this study, 21 strains of heterophilic antibodies were screened. The results showed that these heterophilic antibodies were produced due to the existence of heterophilic antigens between microorganism and human body and the distribution of heterophilic antigens had individual, tissue and species differences. Our study showed that heterophilic antigens exist widely between microorganisms and human body, and the heterophilic antigens carried by microorganisms may break the immune tolerance of the body through carrier effect and initiate immune response, which may be one of the important mechanisms of infection inducing autoimmune diseases.

Updated roles of cGAS-STING signaling in autoimmune diseases.

Natural immunity, the first line for the body to defense against the invasion of pathogen, serves as the body's perception of the presence of pathogens depends on nucleic acid recognition mechanisms. The cyclic GMP-AMP synthase-stimulator of the interferon gene (cGAS-STING) signaling pathway is considered an essential pattern recognition and effector pathway in the natural immune system and is mainly responsible for recognizing DNA molecules present in the cytoplasm and activating downstream signaling pathways to generate type I interferons and some other inflammatory factors. STING, a crucial junction protein in the innate immune system, exerts an essential role in host resistance to external pathogen invasion. Also, STING, with the same character of inflammatory molecules, is inseparable from the body's inflammatory response. In particular, when the expression of STING is upregulated or its related signaling pathways are overactivated, the body may develop serious infectious disorders due to the generation of excessive inflammatory responses, non-infectious diseases, and autoimmune diseases. In recent years, accumulating studies indicated that the abnormal activation of the natural immune cGAS-STING signaling pathway modulated by the nucleic acid receptor cGAS closely associated with the development and occurrence of autoimmune diseases (AID). Thereof, to explore an in-depth role of STING and its related signaling pathways in the diseases associated with inflammation may be helpful to provide new avenues for the treatment of these diseases in the clinic. This article reviews the activation process of the cGAS-STING signaling pathways and its related important roles, and therapeutic drugs in AID, aiming to improve our understanding of AID and achieve better diagnosis and treatment of AID.

An Investigation of Diabetes Mellitus and Vitamin D Deficiency in Patients Presented to Internal Medicine Outpatient Clinic

Introduction: Vitamin D deficiency plays a role also in the occurrence of autoimmune diseases, including heart disease, cancer, inflammatory bowel diseases, diabetes, and rheumatological diseases. In addition, vitamin B12 deficiency, one of the autoimmune diseases, can also be seen in cases of Vitamin D deficiency. Furthermore, Vitamin D is also associated with insulin secretion and increased insulin sensitivity in target cells, and relevant studies reported Vitamin D deficiency at the initial stage of diabetes mellitus (DM). Accordingly, the present study aimed to investigate the relationship between Vitamin D, DM, Vitamin B12, and ferritin in patients presented to the internal medicine outpatient clinic. Materials and Methods: The data from adults aged 18 years and over, who presented to the Internal Medicine Outpatient Clinic of the Mersin City Training and Research Hospital between 01 June 2021 and 31 December 2021 were retrospectively investigated. Results: 476 (95.2%) patients had vitamin D levels below 30 ng/ml, 20 (4.0%) had vitamin B12 levels below 200 pg/ml, and 319 (63.8%) patients had ferritin levels below 20 ng/ml. There was a significant decrease in ferritin in female gender (p

Potential medicinal value of N6-methyladenosine in autoimmune diseases and tumours.

Autoimmune diseases (ADs) are closely related to malignant tumours. On the one hand, ADs can increase the incidence of tumours; on the other hand, malignant tumours can cause rheumatic disease-like manifestations. With the increasing depth of analysis into the mechanism of N6 -methyladenosine (m6A) modification, it has been found that changes in m6A-related modification enzymes are closely related to the occurrence and development of ADs and malignant tumours. In this review, we explore the pathogenesis of ADs and tumours based on m6A modification. According to systematic assessment of the similarities between ADs and tumours, m6A may represent a common target of both diseases. At present, most of the drugs targeting m6A are in the research and development stage, not in clinical trials. Therefore, advancing the development of drugs targeting m6A is of great significance for both the combined treatment of ADs and malignant tumours and improving the quality of life and prognosis of patients.

Einfluss der traumazentrierten Psychotherapie mit EMDR-Therapie auf somatische Komorbiditäten

Results of modern research show a relationship between emotional stress and the occurrence of autoimmune diseases as a comorbidity. The authors use EMDR therapy (Eye Movement Desensitization and Reprocessing) to treat trauma disorders. They wondered whether and to what extent this treatment also affects autoimmune processes. Parallel to the trauma-focused psychotherapy with EMDR, the thyroid hormone substitution dose was documented in patients with active Hashimoto's autoimmune thyroiditis requiring substitution. Hashimoto's autoimmune thyroiditis had already been diagnosed by a specialist and drug treatment had been initiated before starting outpatient psychotherapy. So far in five cases a decrease in autoimmune activity and a stability of the results in the follow-up between six months and one year could be observed. It is now necessary to examine whether these results can be confirmed in a larger number of patients and a diversity of therapists and whether these observations can be transferred to other somatic comorbidities.

Clinical characteristics of myasthenia gravis (MG) patients developing other autoimmune diseases after thymectomy from one single center cohort.

Myasthenia gravis (MG) patients are reported to have a high risk of other autoimmune diseases (ADs), and thymectomy may increase the risk further. A cohort of MG patients in which thymectomy was performed were investigated to analyze the prevalence, types and features of the new onset ADs. Consecutive patients with MG who underwent thymectomy at Beijing Hospital between January 2012 and August 2021 were retrospectively enrolled. Patients with a postoperative follow-up period shorter than a year or incomplete clinical records were excluded. Clinical and follow-up data were collected. Statistical analyses were performed using SPSS version 22.0. A total of 445 patients were included in this study. The median follow-up period was 72 months (range, 12-135 months). A total of 63 (14.2%) MG patients had concurrent ADs. The incidence rate was higher than the background prevalence of population (5%), and also higher than that of a former Chinese MG cohort (11.6%). A total of 47 patients (10.6%) were diagnosed with ADs before thymectomy, and 19 (4.3%) developed a new AD after thymectomy. The most common types of new onset ADs after thymectomy were Hashimoto's thyroiditis and rheumatoid arthritis (RA), which were different from those before thymectomy (hyperthyroidism and Hashimoto's thyroiditis). The incidence rate of new onset RA (1.35%) was higher than the frequency of RA before thymectomy (0.45%), and also higher than the incidence rate in a Chinese MG cohort (0.5%). There was a higher proportion of female patients (p= 0.026) with postoperative ADs. A younger age at operation may increase the risk of nonthymoma MG patients (p= 0.040) developing ADs. The postoperative treatment effect of MG was similar between patients with and without new onset ADs (p> 0.05). We observed a higher incidence rate of autoimmune diseases, especially rheumatoid arthritis, in MG patients after thymectomy. The most common types of ADs after thymectomy were different from those before thymectomy. New onset ADs tended to occur in female and young nonthymoma MG patients. The postoperative effect of MG was not related with the new occurrence of ADs.

Comorbidities in Patients before Surgical Myocardial Revascularization: Current State of the Problem. Part I

Every year we see an increase in the number of patients with indications for surgical treatment of coronary artery disease. In addition to the difficulties of the cardiac surgery process, no less important is the therapeutic support of patients, which in addition to cardiac subtleties requires guidance in concomitant nosologies. As the age of patients increases, there is a higher comorbidity which is associated with difficult management of patients, extensive prescription of drugs and higher cost of medical care.
 The aim. To analyze the current literature data on comorbidity in patients hospitalized for coronary artery bypass grafting.
 Results. According to the literature data, there is a high Charlson comorbidity index, in average 5.7 ± 1.7, in the baseline status of patients with coronary artery disease. High comorbidity index is known for its negative effect on the functioning of grafts in the long-term period after surgical myocardial revascularization. Among patients who underwent surgical revascularization of the myocardium, 22.8–46.9% had diabetes mellitus, 37.5% had obesity, 1.1% had rheumatoid arthritis and 10–12% suffered from chronic kidney disease. There is no statistical data on preoperative status of gastrointestinal tract, but the main complications and predictors of death were identified. Due to the increase in the occurrence of autoimmune diseases on the background of the COVID-19 pandemic, an increase in the number patients with connective tissue diseases in cardiac surgery is predicted, and perioperative management of such patients has its own characteristics and requires further in-depth study.
 Conclusions. Searching for comorbidity in cardiac surgery patients with coronary artery disease is an important component of their preoperative preparation and risk stratification. The influence of type 2 diabetes mellitus, obesity, autoimmune diseases, chronic kidney disease on the occurrence of postoperative complications and the result of surgical myocardial revascularization has been proven. SARS-CoV-2 infection in the surgical treatment of coronary artery disease is another challenge of today that requires further observation and research to help address prognosis, complications, and mortality.

Risk of Progression to Autoimmune Disease in Severe Drug Eruption: Risk Factors and the Factor-Guided Stratification

The identification of risk factors is key not only to uncover the pathogenesis of autoimmune disease but also to predict progression to autoimmune disease. Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms is likely the best prototypic example for analyzing the sequential events. We conducted a retrospective study of 55 patients with drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms followed up for the possibility of later development of autoimmune disease ∼18 years after resolution. Nine patients progressed to autoimmune sequelae regardless of treatment. The generation of autoantibodies was preceded by 8 years in eight of the nine patients. The combination of increases in lymphocyte counts, severe liver damage, a rebound increase in globulin, persistent reactivations of Epstein‒Barr virus and human herpesvirus-6, and low IL-2 and IL-4 at the acute/subacute phases were significant risk factors for the future development of autoimmune disease. On the basis of these factors, we established a scoring system that can identify high-risk patients. When stratified these patients into three risk categories (low/intermediate/high), occurrence of autoimmune disease was exclusively detected in the high group. Our data represent a scoring system to identify patients at high risk of developing autoimmune disease, although a larger study is required to validate the scoring system.

Primary biliary cirrhosis associated with myasthenia gravis after postpartum: a case report

BackgroundAutoimmune diseases refers to a class of diseases involving abnormal immune response of human body and tissue damage caused by the dysregulation of autoimmune balance or destruction of immune tolerance. Recent research has revealed that the occurrence of autoimmune diseases is influenced by genetic, hormonal, immunological, and environmental factors. As sex hormone levels change obviously during pregnancy and postpartum, the morbidity and recurrence rate of autoimmune diseases increase during this period.Case presentationA 31-year-old Asian woman was admitted to our hospital for myasthenia gravis and treated with methylprednisolone and pyridostigmine bromide 3 months postpartum. Physical examination and laboratory inspection after admission suggested that the patient had primary biliary cirrhosis. Subsequently, azathioprine was added to the treatment, and the symptoms of both diseases were successfully controlled.ConclusionsThis case exhibits a rare condition of myasthenia gravis combined with primary biliary cirrhosis postpartum. Given the fluctuation of the immune status during the postpartum period, combined autoimmune diseases need to be taken into account when patients develop clinical symptoms of an autoimmune disease. Therefore, detailed physical and laboratory examination can help to prevent the missed diagnosis of these diseases.

Prevalence and Risk Factors Associated with the Occurrence of Autoimmune Diseases in Patients with Alopecia Areata.

BackgroundIncreased rates of autoimmune diseases (ADs) have been reported in association with alopecia areata (AA); however, the risk factors for coexisting ADs in AA patients have been poorly investigated.ObjectiveTo evaluate the prevalence and factors associated with AD comorbidities in patients with AA.MethodsThis case–control study included patients diagnosed with AA between January 2000 and March 2020. Individuals with AA, both with and without concomitant ADs, were statistically compared. Variables significantly associated with coexisting ADs were identified using univariate and multivariate logistic regression analyses. Multinomial logistic regression analysis was performed to identify the specific risk factors for each concomitant AD.ResultsAmong the 615 patients with AA, comorbid ADs were found in 76 (12.4%). Autoimmune thyroid disease (AITD) exhibited the highest frequency (n = 42, 6.8%), followed by vitiligo (n = 15, 2.4%), and systemic lupus erythematosus (SLE) (n = 12, 2.0%). Logistic regression analyses revealed that female sex (odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.24–4.82; P = 0.011), nail abnormalities (OR = 2.49, 95% CI = 1.14–5.46; P = 0.023), and atopic diseases (OR = 1.98, 95% CI = 1.09–2.43; P < 0.001) were significantly associated with coexisting ADs. Regarding each concomitant AD, nail abnormalities were an associated factor for AITD (OR = 4.65, 95% CI = 1.96–7.24; P = 0.01), whereas coexisting atopic diseases were demonstrated as a predictor of vitiligo (OR = 2.48, 95% CI = 1.43–4.58; P = 0.02). Female sex (OR = 1.61, 95% CI = 1.18–4.27; P = 0.04) and family history of AD (OR = 1.85, 95% CI = 1.26–4.19; P = 0.03) were predictors of SLE.ConclusionThis study suggests that female AA patients with nail abnormalities and atopic diseases have increased rates of AD comorbidities. A thorough review of systems for associated factors can help physicians screen for concomitant ADs.

Beneficial vs Adverse Role of Food in Autoimmune disease: A Controversy

Autoimmune diseases are elaborated as the failure of white blood cells (WBS’s) auto-tolerance system thus, creating a loop of inactivity of immune response. Imbalance WBC’s activation initiates the autoantigens production that leads to tissue damage in body. It is estimated that autoimmune diseases beat the prevalence of cardiovascular diseases along with cancer in all over the world. Women are more likely to suffer as compared to men. Some of the prevailing autoimmune disease includes rheumatoid arthritis, multiple sclerosis, Crohn’s and celiac disease and several more. Autoimmune diseases have two main factors, non-modifiable such as age, gender, genetic history and past infection history. On the other side, modifiable factors are one that can be changed to cure or reduce the chances of autoimmune disease. Dietary patterns are one of the leading modifiable factors in autoimmune disease. It has been concluded that the type of food we consume, plays a huge role in occurrence or as a therapy to treat autoimmune disease. It all depends on the type of food we eat. Autoimmune diseases may cause dysbiosis, disturbed microflora, inflammation in intestine and systematic inflammation in the body.&#x0D; Consuming excessive amount of vegetable oil, trans fats and hydrogenated oils results in the occurrence of autoimmune disease. However, omega-3 fatty acid enriched diet along with antioxidant supplementation, shields the body from lymphocytes disturbed mechanism in immune system. Emerging techniques in researches proofs that intake of whole and natural foods and following vegan diet, high fiber intake, gluten free diet with excluding processed food ultimately lowers the dysbiosis thus, reduces the chances of autoimmunity in tissue or organs. Similarly, consuming food with less arachidonic acid in diet or limiting arachidonic acid, upto 6 portions of fruits and vegetables daily and low sodium intake positively support intestinal functions and micro flora. These factors protect the body from etiology of autoimmune diseases. Autoimmunity of human body is one of the vast subjects and requires a lot of research to study the cause, treatment with its inter-related factors. Around 50 million people of US alone suffer from autoimmune diseases and women are more likely to develop autoimmunity as compared to men.&#x0D; As previous data is not enough to conclude that which type of food is beneficial or harmful in the prevalence of autoimmune diseases, so it is necessary to conclude more researches, experiments and surveys to find out the sustainability of certain food in autoimmune disease. Environmental factors also play an integral role along with dietary factors. To understand the relation of food, type of food and its role in triggering the autoimmunity of tissues or organs, we need more researchers to figure out the nature of food components and their interaction with human body. Thus, we can introduce new and safe initiatives to cure autoimmune diseases.

Common variable immunodeficiency disorder: a clinical case

Primary immunodeficiency is a rare congenital pathology associated with failure of immune system, manifested by disturbances of its functions. These defects lead to increased susceptibility of patients to various infectious agents, as well as the development of autoimmune, malignant and other diseases. Primary immunodeficiency is classified as a rare disease, which was previously associated with a poor prognosis with a high risk of mortality in childhood. To date, the emergence of highly effective treatment methods has changed the course and prognosis of these diseases. Clinicians of various specialties increasingly meet with this pathology in everyday practice, including adult age cohorts. In this regard, early diagnosis of primary immunodeficiency in adults becomes relevant, being associated with choosing optimal therapy, prevention of severe internal organ damage, determination of management strategy for the patient, as well as the need to identify inherited disorders and provide information to the patient’s family. Delayed verification of the diagnosis may cause disability of the patient and development of irreversible, often fatal complications. This article presents our own clinical case with a newly diagnosed clinical condition: Common variable immunodeficiency disorder (CVID), the most common form of primary immunodeficiency in adults. The symptoms of common variable immunodeficiency disorder appear in these patients in adulthood, but a high-quality collected history of the disease will allow you to trace symptoms in the patients even since early childhood. There is a common gap for several years between the onset of the disease and clinical diagnosis, since erroneous diagnosis is often made due to non-specific clinical symptoms that resemble other, more frequent diseases. The prognosis of patients with CVID depends on several factors: frequency of infections, structural disorders in the lungs, the occurrence of autoimmune diseases and the success of infection prevention. Thus, a variety of clinical forms of primary immunodeficiency, lack of awareness of doctors about this pathology, complexity of immunological examination in the general medical network lead to the fact that CVID is not diagnosed for long terms, and patients do not receive the necessary pathogenetic therapy. There is a need for drawing attention of doctors of various disciplines to the fact that the recurrent inflammatory processes of various localization, which are difficult to respond to adequate traditional therapy, may be caused by changes in the immune system, including congenital, genetically determined immunodeficiency.

GENERAL FEATURES OF CARIES PATHOGENESIS IN THIRD MOLARS AND AUTOIMMUNE DISEASES

This article presents a literature review, the results of the analysis of random samples of third molars removed for various clinical indications (11 samples). The teeth samples were analyzed visually, then their coronal parts were treated with epoxy plastination technique and prepared polished sections were studied microscopically. The analyzed data demonstrate the pathogenesis of fissure caries in our samples studied can be explained in terms of the direct virulent effect of pathogenic bacteria on the organic matter in the superficial dentin and basal enamel with the formation of auto antigens, which, as a result of sensitization of the local immune system, become the initial source of the carious process spreading to other teeth. This gives grounds to identify it with the pathogenesis of autoimmune pathology. It has been established that carious damage to hard tissues on the smooth surfaces of the dental crown begins with the pulp, when it is vital, and stops as a result of its tissue degeneration. It has been shown that a single latent damage to the hard dental tissues is the initial manifestation of the latent stage of the carious process, while multiple defects indicate its further progression. As for the generally accepted classification of caries, according to which superficial, medium and deep caries are distinguished, then, in our opinion, they should be considered as stages of the further process of carious destruction of hard dental tissues. We can suggest the study of the pathogenesis of carious lesions of third molars is necessary in order to prevent the occurrence of autoimmune diseases and increase the effectiveness of their treatment.

Analysis of Natural Killer cell functions in patients with hereditary hemochromatosis.

Hereditary hemochromatosis (HH) is an autosomal-recessive disorder of the iron metabolism. Patients are typically affected by dysregulated iron levels, which can lead to iron accumulation within essential organs, such as liver, heart and pancreas. Furthermore, many HH patients are also afflicted by several immune defects and increased occurrence of autoimmune diseases that are linked to human homeostatic iron regulator protein (HFE) in the immune response. Here we examined immune cell phenotype and function in 21 HH patients compared to 21 healthy controls with a focus on Natural Killer (NK) cells. We observed increased basal and stimulated production of pro-inflammatory cytokines such as IL-1β or IL-18 in HH patients compared to healthy controls. However, we did not find major changes in the phenotype, the amount or the cytotoxic function of NK cells in HH patients. Instead, our data show a general decrease in the total number of granulocytes in HH patients (2774 ± 958 per μl versus 3457 ± 1122 per μl in healthy controls). These data demonstrate that NK cells of HH patients are not significantly affected and that the patients' treatment by regular phlebotomy is sufficient to avoid systemic iron overload and its consequences to the immune system.