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Sample records for primary immunodeficiencies pid

  1. Primary immunodeficiencies (PIDs) presenting with cytopenias.

    PubMed

    Notarangelo, Luigi D

    2009-01-01

    Autoimmune manifestations are increasingly being recognized as a component of several forms of primary immunodeficiencies (PID). Defects in purging of self-reactive T and B cells, impaired Fas-mediated apoptosis, abnormalities in development and/or function of regulatory T cells, and persistence of immune activation as a result of inability to clear infections have been shown to account for this association. Among autoimmune manifestations in patients with PID, cytopenias are particularly common. Up to 80% of patients with autoimmune lymphoproliferative syndrome (ALPS) have autoantibodies, and autoimmune hemolytic anemia and immune thrombocytopenia have been reported in 23% and 51% of ALPS patients, and may even mark the onset of the disease. ALPS-associated cytopenias are often refractory to conventional treatment and represent a therapeutic challenge. Autoimmune manifestations occur in 22% to 48% of patients with common variable immunodeficiencies (CVIDs), and are more frequent among CVID patients with splenomegaly and granulomatous disease. Finally, autoimmune cytopenias have been reported also in patients with combined immunodeficiency. In particular, autoimmune hemolytic anemia is very common among infants with nucleoside phosphorylase deficiency. While immune suppression may be beneficial in these cases, full resolution of the autoimmune manifestations ultimately depends on immune reconstitution, which is typically provided by hematopoietic cell transplantation.

  2. Immune defects in active mycobacterial diseases in patients with primary immunodeficiency diseases (PIDs).

    PubMed

    Lee, Wen-I; Huang, Jing-Long; Yeh, Kuo-Wei; Jaing, Tang-Her; Lin, Tzou-Yien; Huang, Yhu-Chering; Chiu, Cheng-Hsun

    2011-12-01

    Natural human immunity to the mycobacteria group, including Mycobacterium tuberculosis, Bacille Calmette-Guérin (BCG) or nontuberculous mycobacteria (NTM), and/or Salmonella species, relies on the functional IL-12/23-IFN-γ integrity of macrophages (monocyte/dendritic cell) connecting to T lymphocyte/NK cells. Patients with severe forms of primary immunodeficiency diseases (PIDs) have more profound immune defects involving this impaired circuit in patients with severe combined immunodeficiencies (SCID) including complete DiGeorge syndrome, X-linked hyper IgM syndrome (HIGM) (CD40L mutation), CD40 deficiency, immunodeficiency with or without anhidrotic ectodermal dysplasia (NEMO and IKBA mutations), chronic granulomatous disease (CGD) and hyper IgE recurrent infection syndromes (HIES). The patients with severe PIDs have broader diverse infections rather than mycobacterial infections. In contrast, patients with an isolated inborn error of the IL-12/23-IFN-γ pathway are exclusively prone to low-virulence mycobacterial infections and nontyphoid salmonella infections, known as Mendelian susceptibility to the mycobacterial disease (MSMD) phenotype. Restricted defective molecules in the circuit, including IFN-γR1, IFN-γR2, IL-12p40, IL-12R-β1, STAT-1, NEMO, IKBA and the recently discovered CYBB responsible for autophagocytic vacuole and proteolysis, and interferon regulatory factor 8 (IRF8) for dendritic cell immunodeficiency, have been identified in around 60% of patients with the MSMD phenotype. Among all of the patients with PIDs referred for investigation since 1985, we have identified four cases with the specific defect (IFNRG1 for three and IL12RB for one), presenting as both BCG-induced diseases and NTM infections, in addition to some patients with SCID, HIGM, CGD and HIES. Furthermore, manifestations in patients with autoantibodies to IFN-γ (autoAbs-IFN-γ), which is categorized as an anticytokine autoantibody syndrome, can resemble the relatively persistent

  3. [Basics of primary immunodeficiencies].

    PubMed

    Hernández-Martínez, Claudia; Espinosa-Rosales, Francisco; Espinosa-Padilla, Sara Elva; Hernández-Martínez, Ana Rosa; Blancas-Galicia, Lizbeth

    2016-01-01

    Primary immunodeficiencies (PID) are a heterogeneous group of inherited disorders, the etiology are the defects in the development or function of the immune system. The principal PID manifestations are the infections in early age, malignancy and diseases of immune dysregulation as autoimmunity and allergy. PIDs are genetics disorders and most of them are inherited as autosomal recessive, also this group of diseases is more prevalent in males and in childhood. The antibody immunodeficiency is the PID more common in adults. The more frequent disorders are the infections in the respiratory tract, abscesses, candidiasis, diarrhea, BCGosis etc. Initial approach included a complete blood count and quantification of immunoglobulins. The delay in diagnosis could be explained due to a perception that the recurrent infections are normal process or think that they are exclusively of childhood. The early diagnosis of PID by primary care physicians is important to opportune treatment and better prognosis.

  4. Current Perspectives on Primary Immunodeficiency Diseases

    PubMed Central

    Kumar, Arvind; Teuber, Suzanne S.; Gershwin, M. Eric

    2006-01-01

    Since the original description of X-linked agammaglobulinemia in 1952, the number of independent primary immunodeficiency diseases (PIDs) has expanded to more than 100 entities. By definition, a PID is a genetically determined disorder resulting in enhanced susceptibility to infectious disease. Despite the heritable nature of these diseases, some PIDs are clinically manifested only after prerequisite environmental exposures but they often have associated malignant, allergic, or autoimmune manifestations. PIDs must be distinguished from secondary or acquired immunodeficiencies, which are far more common. In this review, we will place these immunodeficiencies in the context of both clinical and laboratory presentations as well as highlight the known genetic basis. PMID:17162365

  5. PID comes full circle: applications of V(D)J recombination excision circles in research, diagnostics and newborn screening of primary immunodeficiency disorders.

    PubMed

    van Zelm, Menno C; van der Burg, Mirjam; Langerak, Anton W; van Dongen, Jacques J M

    2011-01-01

    The vast majority of patients suffering from a primary immunodeficiency (PID) have defects in their T- and/or B-cell compartments. Despite advances in molecular diagnostics, in many patients no underlying genetic defect has been identified. B- and T-lymphocytes are unique in their ability to create a receptor by genomic rearrangement of their antigen receptor genes via V(D)J recombination. During this process, stable circular excision products are formed that do not replicate when the cell proliferates. Excision circles can be reliably quantified using real-time quantitative (RQ-)PCR techniques. Frequently occurring δREC-ψJα T-cell receptor excision circles (TRECs) have been used to assess thymic output and intronRSS-Kde recombination excision circles (KREC) to quantify B-cell replication history. In this perspective, we describe how TRECs and KRECs are formed during precursor - T- and B-cell differentiation, respectively. Furthermore, we discuss new insights obtained with TRECs and KRECs and specifically how these excision circles can be applied to support therapy monitoring, patient classification and newborn screening of PID.

  6. Attentiveness of pediatricians to primary immunodeficiency disorders

    PubMed Central

    2012-01-01

    Background Primary immunodeficiency (PID) is a cluster of serious disorders that requires special alertness on the part of the medical staff for prompt diagnosis and management of the patient. This study explored PID knowledge and experience among pediatricians of wide educational backgrounds, practicing in the United Arab Emirates (UAE). Method A self-administered questionnaire was used to determine the competency of pediatricians in their knowledge of PID disorders. This study questionnaire included questions on PID signs and symptoms, syndromes associated with immunodeficiency, screening tests, interpreting laboratory tests and case management. The participants were 263 pediatricians of diverse education working in the 27 governmental hospitals in all regions of UAE. Results The overall performance of the pediatricians did not differ based on their age, gender, origin of certification, rank, or years of experience. Of the 50 questions, 20% of pediatricians answered correctly <60% of the questions, 76% answered correctly 60 to 79% of the questions, and 4% answered correctly ≥80% of the questions. Seventeen of the 19 PID signs and symptoms were identified by 55 to 97%. Four of 5 syndromes associated with immunodeficiency were identified by 50 to 90%. Appropriate screening tests were chosen by 64 to 96%. Attention to the laboratory reference range values as function of patient age was notably limited. Conclusions There was a noteworthy deficiency in PID work-up. Therefore, implementing effective educational strategies is needed to improve the competency of pediatricians to diagnose and manage PID disorders. PMID:22846098

  7. Family Physician Perspectives on Primary Immunodeficiency Diseases

    PubMed Central

    Orange, Jordan S.; Seeborg, Filiz O.; Boyle, Marcia; Scalchunes, Christopher; Hernandez-Trujillo, Vivian

    2016-01-01

    Primary immunodeficiency diseases (PIDs) include over 250 diverse disorders. The current study assessed management of PID by family practice physicians. The American Academy of Allergy, Asthma, and Immunology Primary Immunodeficiency Committee and the Immune Deficiency Foundation conducted an incentivized mail survey of family practice physician members of the American Medical Association and the American Osteopathic Association in direct patient care. Responses were compared with subspecialist immunologist responses from a similar survey. Surveys were returned by 528 (of 4500 surveys mailed) family practice physicians, of whom 44% reported following ≥1 patient with PID. Selective immunoglobulin A deficiency (21%) and chronic granulomatous disease (11%) were most common and were followed by significantly more subspecialist immunologists (P < 0.05). Use of intravenously administered immunoglobulin and live viral vaccinations across PID was significantly different (P < 0.05). Few family practice physicians were aware of professional guidelines for diagnosis and management of PID (4 vs. 79% of subspecialist immunologists, P < 0.05). Family practice physicians will likely encounter patients with PID diagnoses during their career. Differences in how family practice physicians and subspecialist immunologists manage patients with PID underscore areas where improved educational and training initiatives may benefit patient care. PMID:27066486

  8. Prevalence of primary immunodeficiency in Korea.

    PubMed

    Rhim, Jung Woo; Kim, Kyung Hyo; Kim, Dong Soo; Kim, Bong Seong; Kim, Jung Soo; Kim, Chang Hwi; Kim, Hwang Min; Park, Hee Ju; Pai, Ki Soo; Son, Byong Kwan; Shin, Kyung Sue; Oh, Moo Young; Woo, Young Jong; Yoo, Young; Lee, Kun Soo; Lee, Kyung Yil; Lee, Chong Guk; Lee, Joon Sung; Chung, Eun Hee; Choi, Eun Hwa; Hahn, Youn Soo; Park, Hyun Young; Kim, Joong Gon

    2012-07-01

    This study represents the first epidemiological study based on the national registry of primary immunodeficiencies (PID) in Korea. Patient data were collected from 23 major hospitals. A total of 152 patients with PID (under 19 yr of age), who were observed from 2001 to 2005, have been entered in this registry. The period prevalence of PID in Korea in 2005 is 11.25 per million children. The following frequencies were found: antibody deficiencies, 53.3% (n = 81), phagocytic disorders, 28.9% (n = 44); combined immunodeficiencies, 13.2% (n = 20); and T cell deficiencies, 4.6% (n = 7). Congenital agammaglobulinemia (n = 21) and selective IgA deficiency (n = 21) were the most frequently reported antibody deficiency. Other reported deficiencies were common variable immunodeficiencies (n = 16), X-linked agammaglobulinemia (n = 15), IgG subclass deficiency (n = 4). Phagocytic disorder was mostly chronic granulomatous disease. A small number of patients with Wiskott-Aldrich syndrome, hyper-IgE syndrome, and severe combined immunodeficiency were also registered. Overall, the most common first manifestation was pneumonia. This study provides data that permit a more accurate estimation PID patients in Korea.

  9. Primary Immunodeficiencies: “New” Disease in an Old Country

    PubMed Central

    Lee, Pamela P W; Lau, Yu-Lung

    2009-01-01

    Primary immunodeficiency disorders (PIDs) are rare inborn errors of the immune system. Patients with PIDs are unique models that exemplify the functional and phenotypic consequences of various immune defects underlying infections, autoimmunity, lymphoproliferation, allergy and cancer. Over 150 PID syndromes were characterized in the past 60 years, with an ever growing list of new entities being discovered. Because of their rarity, multi-center collaboration for pooled data analysis and molecular studies is important to gain meaningful insights into the phenotypic and genetic diversities of PIDs. In this article, we summarize our research findings on PIDs in Chinese population in the past 20 years. Close collaboration among various immunology centers, cross-referrals and systematic data analysis constitute the foundation for research on PIDs. Future directions include establishment of a national PID registry, raising awareness of PIDs and securing sufficient resources for patient care and scientific research. PMID:20003815

  10. Primary immunodeficiency update I: Syndromes associated with eczematous dermatitis

    PubMed Central

    Pichard, Dominique C.; Freeman, Alexandra F.; Cowen, Edward W.

    2015-01-01

    In the past decade, the availability of powerful molecular techniques has accelerated the pace of discovery of several new primary immunodeficiencies (PID) and revealed the biologic basis of other established PID. These genetic advances, in turn, have facilitated more precise phenotyping of associated skin and systemic manifestations and provide a unique opportunity to better understand the complex human immunologic response. These continuing medical education articles will provide an update of recent advances about PID that may be encountered by dermatologists through their association with eczematous dermatitis, infectious, and non-infectious cutaneous manifestations. Part I will discuss new primary immunodeficiencies that have an eczematous dermatitis. Part II will focus on primary immunodeficiencies that greatly increase susceptibility to fungal infection and the noninfectious presentations of PID. PMID:26282794

  11. Thirty years of primary immunodeficiencies in Turkey.

    PubMed

    Sanal, Ozden; Tezcan, Ilhan

    2011-11-01

    Turkey, with its population of some 75 million, has a high rate of consanguineous marriages. Because the majority of the primary immunodeficiencies (PIDs) are inherited as autosomal recessive (AR) forms, the high consanguinity rate leads to a high prevalence of PID diseases in Turkey. The first pediatric immunology division was established in 1972, since then over 10 other immunology divisions have been established in different cities. Approximately 4,000 patients with possible PID are referred to these centers annually. The percentages of some of the major immunodeficiency groups and individual disease numbers among these patients differ somewhat in comparison with Western countries, likely because the relative incidences of PIDs with AR inheritance and of rare diseases are higher. These characteristics of the patient population, and our determination of differences in disease presentation and unusual features, have led us to undertake studies in collaboration with various centers in Western countries. These collaborations have contributed to the identification of the genes responsible for some rare immunodeficiencies, to the resolution of the genetic heterogeneity underlying conventional phenotypes, and to the description of new clinical phenotypes.

  12. Utility of Next Generation Sequencing in Clinical Primary Immunodeficiencies

    PubMed Central

    Raje, Nikita; Soden, Sarah; Swanson, Douglas; Ciaccio, Christina E.; Kingsmore, Stephen F.; Dinwiddie, Darrell L.

    2015-01-01

    Primary immunodeficiencies (PIDs) are a group of genetically heterogeneous disorders that present with very similar symptoms, complicating definitive diagnosis. More than 240 genes have hitherto been associated with PIDs, of which more than 30 have been identified in the last 3 years. Next generation sequencing (NGS) of genomes or exomes of informative families has played a central role in the discovery of novel PID genes. Furthermore, NGS has the potential to transform clinical molecular testing for established PIDs, allowing all PID differential diagnoses to be tested at once, leading to increased diagnostic yield, while decreasing both the time and cost of obtaining a molecular diagnosis. Given that treatment of PID varies by disease gene, early achievement of a molecular diagnosis is likely to enhance treatment decisions and improve patient outcomes. PMID:25149170

  13. Neutropenia in primary immunodeficiency

    PubMed Central

    Sokolic, Robert

    2016-01-01

    Purpose of review Neutropenia is a feature of several primary immunodeficiency diseases (PIDDs). Because of the diverse pathophysiologies of the PIDDs and the rarity of each disorder, data are often lacking, leading to the necessity of empiric treatment. Recent developments in the understanding of neutropenia in several of the PIDDs make a review of the data timely. Recent findings The category of severe congenital neutropenia continues to expand. Mutations in G6PC3 have been identified as the cause of neutropenia in a minority of previously molecularly undefined cases. Recent advances have broadened our understanding of the pathophysiology and the clinical expression of this disorder. A possible function of the C16orf57 gene has been hypothesized that may explain the clinical overlap between Clerucuzio-type poikiloderma with neutropenia and other marrow diseases. Plerixafor has been shown to be a potentially useful treatment in the warts, hypogammaglobulinemia, infection, and myelokathexis syndrome. Investigations of patients with adenosine deaminase deficient severe combined immunodeficiency have identified neutropenia, and particularly susceptibility to myelotoxins, as a feature of this disorder. Granulocyte-colony stimulating factor is the treatment of choice for neutropenia in PIDD, whereas hematopoietic cell transplantation is the only curative option. Summary The number of PIDDs associated with neutropenia has increased, as has our understanding of the range of phenotypes. Additional data and hypotheses have been generated helping to explain the diversity of presentations of neutropenia in PIDDs. PMID:23196894

  14. Primary Immunodeficiency Diseases: An Update on the Classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency

    PubMed Central

    Al-Herz, Waleed; Bousfiha, Aziz; Casanova, Jean-Laurent; Chatila, Talal; Conley, Mary Ellen; Cunningham-Rundles, Charlotte; Etzioni, Amos; Franco, Jose Luis; Gaspar, H. Bobby; Holland, Steven M.; Klein, Christoph; Nonoyama, Shigeaki; Ochs, Hans D.; Oksenhendler, Erik; Picard, Capucine; Puck, Jennifer M.; Sullivan, Kate; Tang, Mimi L. K.

    2014-01-01

    We report the updated classification of primary immunodeficiencies (PIDs) compiled by the Expert Committee of the International Union of Immunological Societies. In comparison to the previous version, more than 30 new gene defects are reported in this updated version. In addition, we have added a table of acquired defects that are phenocopies of PIDs. For each disorder, the key clinical and laboratory features are provided. This classification is the most up-to-date catalog of all known PIDs and acts as a current reference of the knowledge of these conditions and is an important aid for the molecular diagnosis of patients with these rare diseases. PMID:24795713

  15. Primary immunodeficiency in the neonate: Early diagnosis and management.

    PubMed

    Walkovich, Kelly; Connelly, James A

    2016-02-01

    Many primary immunodeficiencies (PIDs) manifest in the neonatal period but can be challenging to diagnose and manage optimally. In part, the difficulty stems from the natural immaturity of the neonatal immune system that may mask immune deficits and/or complicate interpretation of clinical findings and laboratory assays. The great diversity of PIDs--from innate immune system defects to those that impact the humoral and/or cellular components of the adaptive immune system--and the rapid rate at which new PIDs are being discovered makes it challenging for practitioners to stay current. Moreover, recent appreciation for immune deficiencies that lead to autoinflammation and autoimmunity have broadened the spectrum of neonatal PID, adding additional complexity to an already intricate field. This article serves to highlight the deficiencies in the neonatal immune system, while providing a review of the more common PIDs that present in the neonate and guidelines for diagnosis and supportive care.

  16. Frequency and clinical manifestations of patients with primary immunodeficiency disorders in Iran: update from the Iranian Primary Immunodeficiency Registry.

    PubMed

    Rezaei, Nima; Aghamohammadi, Asghar; Moin, Mostafa; Pourpak, Zahra; Movahedi, Masoud; Gharagozlou, Mohammad; Atarod, Lida; Ghazi, Bahram Mirsaeid; Isaeian, Anna; Mahmoudi, Maryam; Abolmaali, Kamran; Mansouri, Davoud; Arshi, Saba; Tarash, Naser Javaher; Sherkat, Roya; Akbari, Hedayat; Amin, Reza; Alborzi, Abdolvahab; Kashef, Sara; Farid, Reza; Mohammadzadeh, Iraj; Shabestari, Mehrnaz Sadeghi; Nabavi, Mohammad; Farhoudi, Abolhassan

    2006-11-01

    Primary immunodeficiency disorders (PID) are a heterogeneous group of diseases, characterized by an increased susceptibility to infections. A total of 930 patients (573 males and 357 females) are registered in Iranian PID Registry (IPIDR) during three decades. Predominantly antibody deficiencies were the most common (38.4%), followed by congenital defects of phagocyte number and/or function (28.3%), other well-defined immunodeficiency syndromes (17.7%), combined T- and B-cell immunodeficiencies (11.0%), complement deficiencies (2.4%), and diseases of immune dysregulation (2.3%). Common variable immunodeficiency was the most frequent disorder (20.8%), followed by chronic granulomatous disease, ataxia-telangiectasia, btk deficiency, selective IgA deficiency, and T-B-severe combined immunodeficiency. The frequency of other PID disorders was less than 50 in number (<5%). There is an increasing trend in recognition of more PID in the recent years. Construction of such registry is not only important for its epidemiological aspect but also for its role in increasing the physician's knowledge about such disorders.

  17. Hematopoietic stem cell transplantation for primary immunodeficiency diseases.

    PubMed

    Slatter, Mary A; Cant, Andrew J

    2011-11-01

    Hematopoietic stem cell transplantation (HSCT) is now highly successfully curing a widening range of primary immunodeficiencies (PIDs). Better tissue typing, matching of donors, less toxic chemotherapy, better virus detection and treatment, improved supportive care, and graft-versus-host disease prophylaxis mean up to a 90% cure for severe combined immunodeficiency patients and a 70-80% cure for other PIDs given a matched unrelated donor, and rising to 95% for young patients with specific PIDs, such as Wiskott-Aldrich syndrome. Precise molecular diagnosis, detailed data on prognosis, and careful pre-HSCT assessment of infective lung and liver damage will ensure an informed benefit analysis of HSCT and the best outcome. It is now recognized that the best treatment option for chronic granulomatous disease is HSCT, which can also be curative for CD40 ligand deficiency and complex immune dysregulation disorders.

  18. [Replacement therapy with subcutaneous immunoglobulin in primary immunodeficiency in children].

    PubMed

    Pac, Małgorzata

    2011-06-01

    Primary antibody deficiency (PAD) is the most common form of primary immunodeficiency (PID), and presents up to 60-70% of PID. The hallmark of PAD are low antibody level and recurrent infections. Patients require life-long immunoglobulin replacement therapy. Now they can be treated either with intravenous (IVIG) or subcutaneous (SCIG) immunoglobulin. The last one is indicated in patients with unacceptable adverse reactions to the intravenous immunoglobulin preparations, with poor vein access or willing to improve the quality of their life. Several data and clinical trials proved that SCIG therapy is at least as safe and efficacious as IVIG to prevent infections in patients with PAD.

  19. Primary immunodeficiency update II: Syndromes associated with mucocutaneous candidiasis and non-infectious cutaneous manifestations

    PubMed Central

    Pichard, Dominique C.; Freeman, Alexandra F.; Cowen, Edward W.

    2015-01-01

    Several primary immunodeficiencies (PID) have recently been described which confer elevated risk of fungal infections as well as non-infectious cutaneous manifestations. In addition, immunological advances have provided new insights into our understanding of the pathophysiology of fungal infections in established PID. We reviewed PID that present with an eczematous dermatitis in Part I. In Part II, we will discuss updates on PID associated with fungal infections and their biological basis in PID as well as non-infectious cutaneous manifestations. PMID:26282795

  20. The 2015 IUIS Phenotypic Classification for Primary Immunodeficiencies.

    PubMed

    Bousfiha, Aziz; Jeddane, Leïla; Al-Herz, Waleed; Ailal, Fatima; Casanova, Jean-Laurent; Chatila, Talal; Conley, Mary Ellen; Cunningham-Rundles, Charlotte; Etzioni, Amos; Franco, Jose Luis; Gaspar, H Bobby; Holland, Steven M; Klein, Christoph; Nonoyama, Shigeaki; Ochs, Hans D; Oksenhendler, Eric; Picard, Capucine; Puck, Jennifer M; Sullivan, Kathleen E; Tang, Mimi L K

    2015-11-01

    There are now nearly 300 single-gene inborn errors of immunity underlying phenotypes as diverse as infection, malignancy, allergy, auto-immunity, and auto-inflammation. For each of these five categories, a growing variety of phenotypes are ascribed to Primary Immunodeficiency Diseases (PID), making PIDs a rapidly expanding field of medicine. The International Union of Immunological Societies (IUIS) PID expert committee (EC) has published every other year a classification of these disorders into tables, defined by shared pathogenesis and/or clinical consequences. In 2013, the IUIS committee also proposed a more user-friendly, phenotypic classification, based on the selection of key phenotypes at the bedside. We herein propose the revised figures, based on the accompanying 2015 IUIS PID EC classification.

  1. Primary immunodeficiencies underlying fungal infections

    PubMed Central

    Lanternier, Fanny; Cypowyj, Sophie; Picard, Capucine; Bustamante, Jacinta; Lortholary, Olivier; Casanova, Jean-Laurent; Puel, Anne

    2014-01-01

    Purpose of review We review the primary immunodeficiencies underlying an increasing variety of superficial and invasive fungal infections. We also stress that the occurrence of such fungal infections should lead physicians to search for the corresponding single-gene inborn errors of immunity. Finally, we suggest that other fungal infections may also result from hitherto unknown inborn errors of immunity, at least in some patients with no known risk factors. Recent findings An increasing number of primary immunodeficiencies are being shown to underlie fungal infectious diseases in children and young adults. Inborn errors of the phagocyte NADPH oxidase complex (chronic granulomatous disease), severe congenital neutropenia and leukocyte adhesion deficiency type I confer a predisposition to invasive aspergillosis and candidiasis. More rarely, inborn errors of IFN-γ immunity underlie endemic mycoses. Inborn errors of IL-17 immunity have recently been shown to underlie chronic mucocutaneous candidiasis, whereas inborn errors of CARD9 immunity underlie deep dermatophytosis and invasive candidiasis. Summary Chronic mucocutaneous candidiasis, invasive candidiasis, invasive aspergillosis, deep dermatophytosis, pneumocystosis, and endemic mycoses can all be caused by primary immunodeficiencies. Each type of infection is highly suggestive of a specific type of primary immunodeficiency. In the absence of overt risk factors, single-gene inborn errors of immunity should be sought in children and young adults with these and other fungal diseases. PMID:24240293

  2. Chapter 27: Approach to primary immunodeficiency.

    PubMed

    Uzzaman, Ashraf; Fuleihan, Ramsay L

    2012-01-01

    Primary immunodeficiency diseases (PID) are inherited defects of the innate or adaptive arms of the immune system that lead to an increase in the incidence, frequency, or severity of infections. There may be defects in the adaptive arm of the immune system that include combined immunodeficiency and antibody deficiency syndromes or by abnormalities in innate immunity such as disorders of phagocytes, the complement pathway, or Toll-Like receptor (TLR) mediated signaling. Recurrent sinopulmonary infections with encapsulated bacteria such as Haemophilus influenza type B or Streptococcus pneumoniae may be characteristic of an IgG antibody deficiency or dysfunction. Frequent viral, fungal, or protozoal infections may suggest T lymphocyte dysfunction. Multiple staphylococcal skin infections and fungal infections may imply neutrophil dysfunction or the hyper-IgE syndrome, and recurrent neisserial infection is a characteristic manifestation of late complement component (C5-9, or the membrane attack complex) defects. Recurrent viral or pyogenic bacterial infections often without the presence of a significant inflammatory response suggest a defect in TLR signaling. Mycobacterial infections are characteristic of defects in interleukin (IL)-12, interferon (IFN) gamma, or their receptors. Screening of newborns for T-cell lymphopenia using a polymerase chain reaction to amplify T-cell receptor excision circles (TRECs), which are formed when a T cell rearranges the variable region of its receptor, serves as a surrogate for newly synthesized naïve T cells. Because of very low numbers of TRECs, severe combined immunodeficiency, DiGeorge syndrome, and other causes of T-cell lymphopenia have been identified in newborns.

  3. Increased Incidence of Fatigue in Patients with Primary Immunodeficiency Disorders: Prevalence and Associations Within the US Immunodeficiency Network Registry

    PubMed Central

    Guffey, Danielle; Minard, Charles G.; Orange, Jordan S.

    2017-01-01

    Introduction Patients with primary immunodeficiency (PID) often report fatigue, yet this symptom has not been studied in PID. Fatigue affects 6–7.5% of healthy adults. The goal of this study is to estimate the prevalence of fatigue in patients with PID and investigate its associated factors. Methods We analyzed 2537 PID patients registered in USIDNET to determine responses to the field “fatigue” in the core registry form. Demographics, immune phenotypes, and comorbid conditions were compared between fatigued and non-fatigued patients to identify relevant associations and potential drivers. A focused analysis was performed for patients with predominantly antibody deficiency disorders (PADs). Results Fatigue was reported in 25.9%(95% CI 23.7–28.3) of PAD patients, compared to 6.4% (95% CI 4.9–8.2) of non-PAD. Patients with common variable immunodeficiency (CVID) had the highest prevalence of fatigue (p < 0.001) among all PID diagnoses. Other factors that were associated with a higher rate of fatigue among PAD patients included female sex, higher BMI, depression, bronchiectasis, and autoimmunity. Additionally, fatigued PAD patients had lower absolute lymphocyte, CD3, CD4, and CD8 counts compared to non-fatigued patients. Conclusion Our findings suggest that fatigue is overrepresented in PAD patients. Prospective studies to estimate prevalence, risk factors, and fatigue etiology in PID are warranted, so therapeutic interventions can be considered. PMID:28124237

  4. Immunodeficiencies

    PubMed Central

    Ballow, M; Notarangelo, L; Grimbacher, B; Cunningham-Rundles, C; Stein, M; Helbert, M; Gathmann, B; Kindle, G; Knight, A K; Ochs, H D; Sullivan, K; Franco, J L

    2009-01-01

    Primary immunodeficiencies (PIDs) are uncommon, chronic and severe disorders of the immune system in which patients cannot mount a sufficiently protective immune response, leading to an increased susceptibility to infections. The treatment of choice for PID patients with predominant antibody deficiency is intravenous immunoglobulin (Ig) replacement therapy. Despite major advances over the last 20 years in the molecular characterization of PIDs, many patients remain undiagnosed or are diagnosed too late, with severe consequences. Various strategies to ensure timely diagnosis of PIDs are in place, and novel approaches are being developed. In recent years, several patient registries have been established. Such registries shed light on the pathology and natural history of these varied disorders. Analyses of the registry data may also reveal which patients are likely to respond well to higher Ig infusion rates and may help to determine the optimal dosing of Ig products. Faster infusion rates may lead to improved convenience for patients and thus increase patient compliance, and may reduce nursing time and the need for hospital resources. Data from two recent studies suggest that Gamunex® and Privigen® are well tolerated at high infusion rates. Nevertheless, careful selection of patients for high infusion rates, based on co-morbid conditions and tolerance of the current infusion rate, is advisable. Based on the available data, intravenous Ig offers broad protection against encapsulated organisms. As vaccine trends change, careful monitoring of specific antibody levels in the general population, such as those against pneumococcal and meningococcal bacteria, should be implemented. PMID:19883420

  5. Novel primary immunodeficiency candidate genes predicted by the human gene connectome.

    PubMed

    Itan, Yuval; Casanova, Jean-Laurent

    2015-01-01

    Germline genetic mutations underlie various primary immunodeficiency (PID) diseases. Patients with rare PID diseases (like most non-PID patients and healthy individuals) carry, on average, 20,000 rare and common coding variants detected by high-throughput sequencing. It is thus a major challenge to select only a few candidate disease-causing variants for experimental testing. One of the tools commonly used in the pipeline for estimating a potential PID-candidate gene is to test whether the specific gene is included in the list of genes that were already experimentally validated as PID-causing in previous studies. However, this approach is limited because it cannot detect the PID-causing mutation(s) in the many PID patients carrying causal mutations of as yet unidentified PID-causing genes. In this study, we expanded in silico the list of potential PID-causing candidate genes from 229 to 3,110. We first identified the top 1% of human genes predicted by the human genes connectome to be biologically close to the 229 known PID genes. We then further narrowed down the list of genes by retaining only the most biologically relevant genes, with functionally enriched gene ontology biological categories similar to those for the known PID genes. We validated this prediction by showing that 17 of the 21 novel PID genes published since the last IUIS classification fall into this group of 3,110 genes (p < 10(-7)). The resulting new extended list of 3,110 predicted PID genes should be useful for the discovery of novel PID genes in patients.

  6. Novel Primary Immunodeficiency Candidate Genes Predicted by the Human Gene Connectome

    PubMed Central

    Itan, Yuval; Casanova, Jean-Laurent

    2015-01-01

    Germline genetic mutations underlie various primary immunodeficiency (PID) diseases. Patients with rare PID diseases (like most non-PID patients and healthy individuals) carry, on average, 20,000 rare and common coding variants detected by high-throughput sequencing. It is thus a major challenge to select only a few candidate disease-causing variants for experimental testing. One of the tools commonly used in the pipeline for estimating a potential PID-candidate gene is to test whether the specific gene is included in the list of genes that were already experimentally validated as PID-causing in previous studies. However, this approach is limited because it cannot detect the PID-causing mutation(s) in the many PID patients carrying causal mutations of as yet unidentified PID-causing genes. In this study, we expanded in silico the list of potential PID-causing candidate genes from 229 to 3,110. We first identified the top 1% of human genes predicted by the human genes connectome to be biologically close to the 229 known PID genes. We then further narrowed down the list of genes by retaining only the most biologically relevant genes, with functionally enriched gene ontology biological categories similar to those for the known PID genes. We validated this prediction by showing that 17 of the 21 novel PID genes published since the last IUIS classification fall into this group of 3,110 genes (p < 10−7). The resulting new extended list of 3,110 predicted PID genes should be useful for the discovery of novel PID genes in patients. PMID:25883595

  7. Primary Immunodeficiencies and Inflammatory Disease: A Growing Genetic Intersection

    PubMed Central

    Fodil, Nassima; Langlais, David; Gros, Philippe

    2016-01-01

    Recent advances in genome analysis have provided important insights into the genetic architecture of infectious and inflammatory diseases. The combined analysis of loci detected by genome-wide association studies (GWAS) in 22 inflammatory diseases has revealed a shared genetic core and associated biochemical pathways that play a central role in pathological inflammation. Parallel whole exome sequencing studies have identified 265 genes mutated in primary immunodeficiencies (PID). Here we examine the overlap between these two datasets, and find that it consists of genes essential for protection against infections and in which persistent activation causes pathological inflammation. Based on this intersection, we propose that although strong or inactivating mutations (rare variants) in these genes may cause severe disease (PIDs), their more subtle modulation potentially by common regulatory/coding variants may contribute to chronic inflammation. PMID:26791050

  8. [Lymphocytes B and primary immunodeficiencies].

    PubMed

    López-Herrera, Gabriela

    2016-01-01

    Primary antibody deficiencies represent the most frequent genetic diseases of the immune system and the first to be recognized along immunology history. The antibodies were recognized as part of the humoral immune system long ago, and after immunoglobulin discovery, the first antibody immunodeficiency were recognized and named as "agammaglobulinemia", followed by the common variable immunoendeficiency and the hyper-IgM syndrome. The following discoveries in immunology history made possible the understanding of these pathologies, for example: the discoveries of B cells, pre-B cells, the signaling pathway directed by the antigen receptor and many other cellular and molecular mechanisms. Primary antibody deficiencies have been studied for a long time and the discoveries of new syndromes have been helpful in the understanding of immunological mechanisms that take place in our organism. Then, this manuscript pretends to review the relevant findings in the history of immunology, focused on the B cells and the connection with the description of representative clinical entities of primary antibody deficiencies. The aim of this manuscript is to show to the reader that the generation of scientific knowledge has a direct application in the understanding of the molecular mechanisms that are affected in these diseases.

  9. Primary Immunodeficiency Diseases at Reference and High-Specialty Hospitals in the State of Guanajuato, Mexico

    PubMed Central

    Guaní-Guerra, Eduardo; García-Ramírez, Ulises Noel; Jiménez-Romero, Ana Isabel; Velázquez-Ávalos, José Manuel; Gallardo-Martínez, Gabriela; Mendoza-Espinoza, Francisco-Javier

    2013-01-01

    Background. In general, primary immunodeficiency diseases (PIDs) are underdiagnosed in most countries. The objective of this study was to describe the frequency and clinical spectrum of PID in the most important tertiary hospitals in our region. Methods. An observational, cross-sectional, with retrospective chart, review study was conducted. A total of 26 patients were included and grouped according to the updated classification of PIDs. Results. PIDs spectra were as follows: predominantly antibody deficiency diseases were the most common category (65.38%), followed by other well-defined immunodeficiency syndromes (11.55%), congenital defects of phagocyte number and/or function (7.69%), complement deficiencies (3.85%), combined T- and B-cell immunodeficiencies (3.85%), and defects in innate immunity (3.85%). The mean time elapsed from the onset of symptoms to the reference and diagnosis by a tertiary hospital was of 4.65 ± 6.95 years. Conclusions. Predominant antibody deficiency disease was the most common group of PIDs, agreeing with international reports. Awareness of underdiagnosis by physicians is crucial for a prompt diagnosis and treatment, which in turn should improve the quality of life among patients with PIDs. PMID:24073395

  10. Primary Immunodeficiency Diseases: an Update on the Classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency 2015.

    PubMed

    Picard, Capucine; Al-Herz, Waleed; Bousfiha, Aziz; Casanova, Jean-Laurent; Chatila, Talal; Conley, Mary Ellen; Cunningham-Rundles, Charlotte; Etzioni, Amos; Holland, Steven M; Klein, Christoph; Nonoyama, Shigeaki; Ochs, Hans D; Oksenhendler, Eric; Puck, Jennifer M; Sullivan, Kathleen E; Tang, Mimi L K; Franco, Jose Luis; Gaspar, H Bobby

    2015-11-01

    We report the updated classification of primary immunodeficiencies compiled by the Primary Immunodeficiency Expert Committee (PID EC) of the International Union of Immunological Societies (IUIS). In the two years since the previous version, 34 new gene defects are reported in this updated version. For each disorder, the key clinical and laboratory features are provided. In this new version we continue to see the increasing overlap between immunodeficiency, as manifested by infection and/or malignancy, and immune dysregulation, as manifested by auto-inflammation, auto-immunity, and/or allergy. There is also an increased number of genetic defects that lead to susceptibility to specific organisms which reflects the finely tuned nature of immune defense systems. This classification is the most up to date catalogue of all known and published primary immunodeficiencies and acts as a current reference of the knowledge of these conditions and is an important aid for the genetic and molecular diagnosis of patients with these rare diseases.

  11. Pharmacoeconomics of immunoglobulins in primary immunodeficiency.

    PubMed

    Simoens, Steven

    2009-08-01

    Primary immunodeficiency disorders are associated with increased patient susceptibility to recurrent infections. Since the 1950s, intramuscular, intravenous and subcutaneous immunoglobulin products have been used to replace functionally deficient or absent immunoglobulins, reduce the incidence of infections and prevent organ damage caused by infections. This article aims to review the use of immunoglobulin therapy in primary immunodeficiency by focusing on costs, effectiveness, cost-effectiveness, supply and off-label use. To date, the economic burden of primary immunodeficiency is unknown. Past studies have supported minimal differences in effectiveness between intravenous and subcutaneous immunoglobulins. Subcutaneous therapy may be considered for patients who prefer treatment at home. The small number of economic evaluations and their methodological limitations precludes the recommendation of a specific product for use in primary immunodeficiency on pharmacoeconomic grounds. Demand for immunoglobulins has increased over time, leading to periodic shortages and emphasizing the importance of its appropriate use.

  12. Warts and All: HPV in Primary Immunodeficiencies

    PubMed Central

    Leiding, Jennifer W.; Holland, Steven M.

    2012-01-01

    Infection with human papilloma virus (HPV) is almost universal and eventually asymptomatic, but pathologic infection with HPV is severe, recurrent, and recalcitrant to therapy. It is also an underappreciated manifestation of primary immunodeficiency. Mutations in EVER1, EVER2, GATA2, CXCR4, and DOCK8 are typically associated with extensive HPV infections, whereas several other primary immune defects have severe HPV much less frequently. We review immunodeficiencies with severe HPV infections and the mechanisms underlying them. PMID:23036745

  13. Flow Cytometry, a Versatile Tool for Diagnosis and Monitoring of Primary Immunodeficiencies

    PubMed Central

    Aubert, Geraldine

    2016-01-01

    Genetic defects of the immune system are referred to as primary immunodeficiencies (PIDs). These immunodeficiencies are clinically and immunologically heterogeneous and, therefore, pose a challenge not only for the clinician but also for the diagnostic immunologist. There are several methodological tools available for evaluation and monitoring of patients with PIDs, and of these tools, flow cytometry has gained prominence, both for phenotyping and functional assays. Flow cytometry allows real-time analysis of cellular composition, cell signaling, and other relevant immunological pathways, providing an accessible tool for rapid diagnostic and prognostic assessment. This minireview provides an overview of the use of flow cytometry in disease-specific diagnosis of PIDs, in addition to other broader applications, which include immune phenotyping and cellular functional measurements. PMID:26912782

  14. Clinical applications of gene therapy for primary immunodeficiencies.

    PubMed

    Cicalese, Maria Pia; Aiuti, Alessandro

    2015-04-01

    Primary immunodeficiencies (PIDs) have represented a paradigmatic model for successes and pitfalls of hematopoietic stem cells gene therapy. First clinical trials performed with gamma retroviral vectors (γ-RV) for adenosine deaminase severe combined immunodeficiency (ADA-SCID), X-linked SCID (SCID-X1), and Wiskott-Aldrich syndrome (WAS) showed that gene therapy is a valid therapeutic option in patients lacking an HLA-identical donor. No insertional mutagenesis events have been observed in more than 40 ADA-SCID patients treated so far in the context of different clinical trials worldwide, suggesting a favorable risk-benefit ratio for this disease. On the other hand, the occurrence of insertional oncogenesis in SCID-X1, WAS, and chronic granulomatous disease (CGD) RV clinical trials prompted the development of safer vector construct based on self-inactivating (SIN) retroviral or lentiviral vectors (LVs). Here we present the recent results of LV-mediated gene therapy for WAS showing stable multilineage engraftment leading to hematological and immunological improvement, and discuss the differences with respect to the WAS RV trial. We also describe recent clinical results of SCID-X1 gene therapy with SIN γ-RV and the perspectives of targeted genome editing techniques, following early preclinical studies showing promising results in terms of specificity of gene correction. Finally, we provide an overview of the gene therapy approaches for other PIDs and discuss its prospects in relation to the evolving arena of allogeneic transplant.

  15. Autoimmune and other cytopenias in primary immunodeficiencies: pathomechanisms, novel differential diagnoses, and treatment

    PubMed Central

    2014-01-01

    Autoimmunity and immune dysregulation may lead to cytopenia and represent key features of many primary immunodeficiencies (PIDs). Especially when cytopenia is the initial symptom of a PID, the order and depth of diagnostic steps have to be performed in accordance with both an immunologic and a hematologic approach and will help exclude disorders such as systemic lupus erythematosus, common variable immunodeficiency, and autoimmune lymphoproliferative syndromes, hemophagocytic disorders, lymphoproliferative diseases, and novel differential diagnoses such as MonoMac syndrome (GATA2 deficiency), CD27 deficiency, lipopolysaccharide-responsive beige-like anchor (LRBA) deficiency, activated PI3KD syndrome (APDS), X-linked immunodeficiency with magnesium defect (MAGT1 deficiency), and others. Immunosuppressive treatment often needs to be initiated urgently, which impedes further relevant immunologic laboratory analyses aimed at defining the underlying PID. Awareness of potentially involved disease spectra ranging from hematologic to rheumatologic and immunologic disorders is crucial for identifying a certain proportion of PID phenotypes and genotypes among descriptive diagnoses such as autoimmune hemolytic anemia, chronic immune thrombocytopenia, Evans syndrome, severe aplastic anemia/refractory cytopenia, and others. A synopsis of pathomechanisms, novel differential diagnoses, and advances in treatment options for cytopenias in PID is provided to facilitate multidisciplinary management and to bridge different approaches. PMID:25163701

  16. 2. Update on primary immunodeficiency diseases.

    PubMed

    Bonilla, Francisco A; Geha, Raif S

    2006-02-01

    The pace of discovery in primary immunodeficiency continues to accelerate. In particular, lymphocyte defects have been the source of the most impressive expansion in recent years. Novel forms of agammaglobulinemia, class-switch defects, and T-B(+) severe combined immunodeficiency have been described. Little by little, the genetic heterogeneity of the common variable immunodeficiency and IgA deficiency phenotypes continues to be unraveled as new molecular defects have been reported in these patients as well. The phenotypic spectrum of DiGeorge syndrome has been further developed, along with promising advances in therapy. Defects of nuclear factor kappaB regulation and Toll-like receptor signaling have been described, along with defects of chemokine receptors and cytoplasmic proteases. Clinically defined immunodeficiencies, such as hyper-IgE syndrome and idiopathic CD4 lymphocytopenia, are also discussed. Finally, significant adverse effects in some patients have tempered initial enthusiasm for gene therapy.

  17. [Revertant somatic mosaicism in primary immunodeficiency diseases].

    PubMed

    Wada, Taizo

    2014-01-01

    Revertant somatic mosaicism has been described in an increasing number of genetic disorders including primary immunodeficiency diseases. Both back mutations leading to restoration of wild-type sequences and second-site mutations resulting in compensatory changes have been demonstrated in mosaic individuals. Recent studies identifying revertant somatic mosaicism caused by multiple independent genetic changes further support its frequent occurrence in primary immunodeficiency diseases. Revertant mosaicism acquires a particular clinical relevance because it may lead to selective growth advantage of the corrected cells, resulting in improvement of disease symptoms or atypical clinical presentations. This phenomenon also provides us unique opportunities to evaluate the biological effects of restored gene expression in different cell lineages. Here we review the recent findings of revertant somatic mosaicism in primary immunodeficiency diseases and discuss its clinical implications.

  18. Immunoglobulin Replacement Therapy for Primary Immunodeficiency.

    PubMed

    Sriaroon, Panida; Ballow, Mark

    2015-11-01

    Immunoglobulin replacement therapy has been standard treatment in patients with primary immunodeficiency diseases for the past 3 decades. The goal of therapy is to reduce serious bacterial infections in individuals with antibody function defects. Approximately one-third of patients receiving intravenous immunoglobulin treatment experience adverse reactions. Recent advances in manufacturing processes have resulted in products that are safer and better tolerated. Self-infusion by the subcutaneous route has become popular and resulted in better quality of life. This review summarizes the use of immunoglobulin therapy in primary immunodeficiency diseases including its properties, dosing, adverse effects, and different routes of administration.

  19. Single-institution Experience of Unrelated Cord Blood Transplantation for Primary Immunodeficiency.

    PubMed

    Chang, Tsung-Yun; Jaing, Tang-Her; Lee, Wei-I; Chen, Shih-Hsiang; Yang, Chao-Ping; Hung, Iou-Jih

    2015-04-01

    Pediatric patients with primary immunodeficiencies (PID) constitute life-threatening medical emergencies. In the absence of an HLA-identical hematopoietic stem cell donor, unrelated donor cord blood transplantation (CBT) is another treatment option. There are little data regarding the outcome of unrelated CBT for PID in Taiwan. We report the results of CBT performed in 8 patients with PID between 2004 and 2013 at Chang Gung Memorial Hospital. The cases included severe combined immunodeficiency (n=4), chronic granulomatous disease (n=2), Wiskott-Aldrich syndrome (n=1), and T-cell immunodeficiency (n=1). Median follow-up time was 73 months. Most UCB recipients received a myeloablative conditioning regimen. There were 7 boys and 1 girl with a median age of 2.5 months at diagnosis (range, antenatal to 17 mo). Median age at transplant was 5.5 months (range, 2 to 74 mo). All but 1 patients engrafted at a median time of 14 days. One developed significant grade III graft-versus-host disease after transplant. Our data show that unrelated CBT in PID is possible. However, no definite conclusions can be drawn from this small number of patients, and more studies are needed to further investigate and confirm these findings.

  20. Primary immunodeficiency diseases associated with increased susceptibility to viral infections and malignancies.

    PubMed

    Rezaei, Nima; Hedayat, Mona; Aghamohammadi, Asghar; Nichols, Kim E

    2011-06-01

    Primary immunodeficiencies (PIDs) are commonly characterized by an increased susceptibility to specific infections and, in certain instances, a higher than usual incidence of malignancies. Although improved diagnosis and early treatment of PIDs have reduced early morbidity and mortality from infection, the development of cancer remains a significant cause of premature death. The emergence of cancer in patients with PIDs often results from impairments in the immune response that lead to weakened surveillance against oncogenic viruses, premalignant or malignant cells, or both. Here we review the clinical and biologic features of several PIDs associated with enhanced susceptibility to viral infections and cancer, including X-linked lymphoproliferative disease; IL-2-inducible T-cell kinase deficiency; epidermodysplasia verruciformis; warts, hypogammaglobulinemia, infections, and myelokathexis syndrome; autosomal recessive hyper-IgE syndrome; X-linked agammaglobulinemia; and common variable immunodeficiency. It is of importance that we gain in-depth insights into the fundamental molecular nature of these unique PIDs to better understand the pathogenesis of virus-associated malignancies and to develop innovative therapeutic strategies.

  1. Advances of gene therapy for primary immunodeficiencies

    PubMed Central

    Candotti, Fabio

    2016-01-01

    In the recent past, the gene therapy field has witnessed a remarkable series of successes, many of which have involved primary immunodeficiency diseases, such as X-linked severe combined immunodeficiency, adenosine deaminase deficiency, chronic granulomatous disease, and Wiskott-Aldrich syndrome. While such progress has widened the choice of therapeutic options in some specific cases of primary immunodeficiency, much remains to be done to extend the geographical availability of such an advanced approach and to increase the number of diseases that can be targeted. At the same time, emerging technologies are stimulating intensive investigations that may lead to the application of precise genetic editing as the next form of gene therapy for these and other human genetic diseases. PMID:27508076

  2. Current progress on gene therapy for primary immunodeficiencies.

    PubMed

    Zhang, L; Thrasher, A J; Gaspar, H B

    2013-10-01

    Primary immunodeficiencies have played a major role in the development of gene therapy for monogenic diseases of the bone marrow. The last decade has seen convincing evidence of long-term disease correction as a result of ex vivo viral vector-mediated gene transfer into autologous haematopoietic stem cells. The success of these early studies has been balanced by the development of vector-related insertional mutagenic events. More recently the use of alternative vector designs with self-inactivating designs, which have an improved safety profile has led to the initiation of a wave of new studies that are showing early signs of efficacy. The ongoing development of safer vector platforms and gene-correction technologies together with improvements in cell-transduction techniques and optimised conditioning regimes is likely to make gene therapy amenable for a greater number of PIDs. If long-term efficacy and safety are shown, gene therapy will become a standard treatment option for specific forms of PID.

  3. Gene therapy of primary T cell immunodeficiencies.

    PubMed

    Fischer, Alain; Hacein-Bey-Abina, Salima; Cavazzana-Calvo, Marina

    2013-08-10

    Gene therapy of severe combined immunodeficiencies has been proven to be effective to provide sustained correction of the T cell immunodeficiencies. This has been achieved for 2 forms of SCID, i.e SCID-X1 (γc deficiency) and adenosine deaminase deficiency. Occurrence of gene toxicity generated by integration of first generation retroviral vectors, as observed in the SCID-X1 trials has led to replace these vectors by self inactivated (SIN) retro(or lenti) viruses that may provide equivalent efficacy with a better safety profile. Results of ongoing clinical studies in SCID as well as in other primary immunodeficiencies, such as the Wiskott Aldrich syndrome, will be thus very informative.

  4. Primary immunodeficiency investigation in patients during and after hospitalization in a pediatric Intensive Care Unit

    PubMed Central

    Suavinho, Érica; de Nápolis, Ana Carolina R.; Segundo, Gesmar Rodrigues S.

    2014-01-01

    Objective: To analyze whether the patients with severe infections, admitted in the Pediatric Intensive Care Unit of the Hospital de Clínicas of the Universidade Federal de Uberlândia, underwent the active screening for primary immunodeficiencies (PID). Methods: Retrospective study that assessed the data records of patients with any severe infections admitted in the Pediatric Intensive Care Unit, covering a period from January 2011 to January 2012, in order to confirm if they performed an initial investigation for PID with blood count and immunoglobulin dosage. Results: In the studied period, 53 children were hospitalized with severe infections in the Pediatric Intensive Care Unit, and only in seven (13.2%) the initial investigation of PID was performed. Among these patients, 3/7 (42.8%) showed quantitative alterations in immunoglobulin G (IgG) levels, 1/7 (14.3%) had the diagnosis of cyclic neutropenia, and 1/7 (14.3%) presented thrombocytopenia and a final diagnosis of Wiskott-Aldrich syndrome. Therefore, the PID diagnosis was confirmed in 5/7 (71.4%) of the patients. Conclusions: The investigation of PID in patients with severe infections has not been routinely performed in the Pediatric Intensive Care Unit. Our findings suggest the necessity of performing PID investigation in this group of patients. PMID:24676187

  5. Targeted strategies directed at the molecular defect: Toward precision medicine for select primary immunodeficiency disorders.

    PubMed

    Notarangelo, Luigi D; Fleisher, Thomas A

    2017-03-01

    Primary immunodeficiency disorders (PIDs) represent a range of genetically determined diseases that typically have increased susceptibility to infections and in many cases also have evidence of immune dysregulation that often presents as autoimmunity. Most recently, the concept of gain-of-function mutations associated with PIDs has become well recognized and adds a new dimension to the understanding of this group of disorders, moving beyond the more commonly seen loss-of-function mutations. The rapidly expanding genetic defects that have been identified in patients with previously uncharacterized PIDs has opened up the potential for targeted therapy directed at the specific disease-causing abnormality. This has been driven by linking PID-specific genetic defects to the associated unique abnormalities in cellular signaling pathways amenable to directed therapies. These include agents that either block overactive or enhance underresponsive cellular pathways. Selected primary immunodeficiencies were chosen, the genetic defects of which have been recently characterized and are amenable to targeted therapy, as a reflection of the power of precision medicine.

  6. Comparison of American and European practices in the management of patients with primary immunodeficiencies

    PubMed Central

    Hernandez-Trujillo, H S; Chapel, H; Lo Re III, V; Notarangelo, L D; Gathmann, B; Grimbacher, B; Boyle, J M; Hernandez-Trujillo, V P; Scalchunes, C; Boyle, M L; Orange, J S

    2012-01-01

    Primary immunodeficiency diseases (PIDs) comprise a heterogeneous group of rare disorders. This study was devised in order to compare management of these diseases in the northern hemisphere, given the variability of practice among clinicians in North America. The members of two international societies for clinical immunologists were asked about their management protocols in relation to their PID practice. An anonymous internet questionnaire, used previously for a survey of the American Academy of Allergy, Asthma and Immunology (AAAAI), was offered to all full members of the European Society for Immunodeficiency (ESID). The replies were analysed in three groups, according to the proportion of PID patients in the practice of each respondent; this resulted in two groups from North America and one from Europe. The 123 responses from ESID members (23·7%) were, in the majority, very similar to those of AAAAI respondents, with > 10% of their practice devoted to primary immunodeficiency. There were major differences between the responses of these two groups and those of the general AAAAI respondents whose clinical practice was composed of < 10% of PID patients. These differences included the routine use of intravenous immunoglobulin therapy (IVIg) for particular types of PIDs, initial levels of IVIg doses, dosing intervals, routine use of prophylactic antibiotics, perceptions of the usefulness of subcutaneous immunoglobulin therapy (SCIg) and of the risk to patients' health of policies adopted by health-care funders. Differences in practice were identified and are discussed in terms of methods of health-care provision, which suggest future studies for ensuring continuation of appropriate levels of immunoglobulin replacement therapies. PMID:22670779

  7. Evaluation of primary immunodeficiency disease in children.

    PubMed

    Reust, Carin E

    2013-06-01

    One in 2,000 children younger than 18 years is thought to have a primary immunodeficiency disease. Antibody, combined B-cell and T-cell, phagocytic, and complement disorders are the most common types. Children with these diseases tend to have bacterial or fungal infections with unusual organisms, or unusually severe and recurrent infections with common organisms. A family history of primary immunodeficiency disease is the strongest predictor of a person having this type of disease. When an immunodeficiency disease is suspected, initial laboratory screening should include a complete blood count with differential and measurement of serum immunoglobulin and complement levels. The presence of lymphocytopenia on complete blood count suggests a T-cell disorder, whereas a finding of neutropenia suggests a phagocytic disorder. Abnormal serum immunoglobulin levels suggest a B-cell disorder. Abnormalities on assay of the classic or alternative complement pathways suggest a complement disorder. If laboratory results are abnormal, or if clinical suspicion continues despite normal laboratory results, children should be referred for further evaluation. Human immunodeficiency virus infection should also be considered, and testing should be performed, if appropriate; this infection often clinically resembles a T-cell disorder.

  8. Lentiviral vectors for the treatment of primary immunodeficiencies.

    PubMed

    Farinelli, Giada; Capo, Valentina; Scaramuzza, Samantha; Aiuti, Alessandro

    2014-07-01

    In the last years important progress has been made in the treatment of several primary immunodeficiency disorders (PIDs) with gene therapy. Hematopoietic stem cell (HSC) gene therapy indeed represents a valid alternative to conventional transplantation when a compatible donor is not available and recent success confirmed the great potential of this approach. First clinical trials performed with gamma retroviral vectors were promising and guaranteed clinical benefits to the patients. On the other hand, the outcome of severe adverse events as the development of hematological abnormalities highlighted the necessity to develop a safer platform to deliver the therapeutic gene. Self-inactivating (SIN) lentiviral vectors (LVVs) were studied to overcome this hurdle through their preferable integration pattern into the host genome. In this review, we describe the recent advancements achieved both in vitro and at preclinical level with LVVs for the treatment of Wiskott-Aldrich syndrome (WAS), chronic granulomatous disease (CGD), ADA deficiency (ADA-SCID), Artemis deficiency, RAG1/2 deficiency, X-linked severe combined immunodeficiency (γchain deficiency, SCIDX1), X-linked lymphoproliferative disease (XLP) and immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome.

  9. Dendritic cell analysis in primary immunodeficiency

    PubMed Central

    Bigley, Venetia; Barge, Dawn; Collin, Matthew

    2016-01-01

    Purpose of review Dendritic cells are specialized antigen-presenting cells which link innate and adaptive immunity, through recognition and presentation of antigen to T cells. Although the importance of dendritic cells has been demonstrated in many animal models, their contribution to human immunity remains relatively unexplored in vivo. Given their central role in infection, autoimmunity, and malignancy, dendritic cell deficiency or dysfunction would be expected to have clinical consequences. Recent findings Human dendritic cell deficiency disorders, related to GATA binding protein 2 (GATA2) and interferon regulatory factor 8 (IRF8) mutations, have highlighted the importance of dendritic cells and monocytes in primary immunodeficiency diseases and begun to shed light on their nonredundant roles in host defense and immune regulation in vivo. The contribution of dendritic cell and monocyte dysfunction to the pathogenesis of primary immunodeficiency disease phenotypes is becoming increasingly apparent. However, dendritic cell analysis is not yet a routine part of primary immunodeficiency disease workup. Summary Widespread uptake of dendritic cell/monocyte screening in clinical practice will facilitate the discovery of novel dendritic cell and monocyte disorders as well as advancing our understanding of human dendritic cell biology in health and disease. PMID:27755182

  10. Exome Sequencing Reveals Primary Immunodeficiencies in Children with Community-Acquired Pseudomonas aeruginosa Sepsis.

    PubMed

    Asgari, Samira; McLaren, Paul J; Peake, Jane; Wong, Melanie; Wong, Richard; Bartha, Istvan; Francis, Joshua R; Abarca, Katia; Gelderman, Kyra A; Agyeman, Philipp; Aebi, Christoph; Berger, Christoph; Fellay, Jacques; Schlapbach, Luregn J

    2016-01-01

    One out of three pediatric sepsis deaths in high income countries occur in previously healthy children. Primary immunodeficiencies (PIDs) have been postulated to underlie fulminant sepsis, but this concept remains to be confirmed in clinical practice. Pseudomonas aeruginosa (P. aeruginosa) is a common bacterium mostly associated with health care-related infections in immunocompromised individuals. However, in rare cases, it can cause sepsis in previously healthy children. We used exome sequencing and bioinformatic analysis to systematically search for genetic factors underpinning severe P. aeruginosa infection in the pediatric population. We collected blood samples from 11 previously healthy children, with no family history of immunodeficiency, who presented with severe sepsis due to community-acquired P. aeruginosa bacteremia. Genomic DNA was extracted from blood or tissue samples obtained intravitam or postmortem. We obtained high-coverage exome sequencing data and searched for rare loss-of-function variants. After rigorous filtrations, 12 potentially causal variants were identified. Two out of eight (25%) fatal cases were found to carry novel pathogenic variants in PID genes, including BTK and DNMT3B. This study demonstrates that exome sequencing allows to identify rare, deleterious human genetic variants responsible for fulminant sepsis in apparently healthy children. Diagnosing PIDs in such patients is of high relevance to survivors and affected families. We propose that unusually severe and fatal sepsis cases in previously healthy children should be considered for exome/genome sequencing to search for underlying PIDs.

  11. Exome Sequencing Reveals Primary Immunodeficiencies in Children with Community-Acquired Pseudomonas aeruginosa Sepsis

    PubMed Central

    Asgari, Samira; McLaren, Paul J.; Peake, Jane; Wong, Melanie; Wong, Richard; Bartha, Istvan; Francis, Joshua R.; Abarca, Katia; Gelderman, Kyra A.; Agyeman, Philipp; Aebi, Christoph; Berger, Christoph; Fellay, Jacques; Schlapbach, Luregn J.; Posfay-Barbe, Klara

    2016-01-01

    One out of three pediatric sepsis deaths in high income countries occur in previously healthy children. Primary immunodeficiencies (PIDs) have been postulated to underlie fulminant sepsis, but this concept remains to be confirmed in clinical practice. Pseudomonas aeruginosa (P. aeruginosa) is a common bacterium mostly associated with health care-related infections in immunocompromised individuals. However, in rare cases, it can cause sepsis in previously healthy children. We used exome sequencing and bioinformatic analysis to systematically search for genetic factors underpinning severe P. aeruginosa infection in the pediatric population. We collected blood samples from 11 previously healthy children, with no family history of immunodeficiency, who presented with severe sepsis due to community-acquired P. aeruginosa bacteremia. Genomic DNA was extracted from blood or tissue samples obtained intravitam or postmortem. We obtained high-coverage exome sequencing data and searched for rare loss-of-function variants. After rigorous filtrations, 12 potentially causal variants were identified. Two out of eight (25%) fatal cases were found to carry novel pathogenic variants in PID genes, including BTK and DNMT3B. This study demonstrates that exome sequencing allows to identify rare, deleterious human genetic variants responsible for fulminant sepsis in apparently healthy children. Diagnosing PIDs in such patients is of high relevance to survivors and affected families. We propose that unusually severe and fatal sepsis cases in previously healthy children should be considered for exome/genome sequencing to search for underlying PIDs. PMID:27703454

  12. Overview of Immunodeficiency Disorders

    PubMed Central

    Raje, Nikita; Dinakar, Chitra

    2015-01-01

    Synopsis The spectrum of primary immunodeficiency disorders (PID) is expanding. It includes typical disorders that primarily present with defective immunity as well as disorders that predominantly involve other systems and exhibit few features of impaired immunity. The rapidly growing list of new immunodeficiency disorders and treatment modalities makes it imperative for the provider to stay abreast of the latest and best management strategies. We present a brief overview of recent clinical advances in the field of PIDs. PMID:26454309

  13. The altered landscape of the human skin microbiome in patients with primary immunodeficiencies

    PubMed Central

    Oh, Julia; Freeman, Alexandra F.; Park, Morgan; Sokolic, Robert; Candotti, Fabio; Holland, Steven M.; Segre, Julia A.; Kong, Heidi H.

    2013-01-01

    While landmark studies have shown that microbiota activate and educate host immunity, how immune systems shape microbiomes and contribute to disease is incompletely characterized. Primary immunodeficiency (PID) patients suffer recurrent microbial infections, providing a unique opportunity to address this issue. To investigate the potential influence of host immunity on the skin microbiome, we examined skin microbiomes in patients with rare monogenic PIDs: hyper-IgE (STAT3-deficient), Wiskott-Aldrich, and dedicator of cytokinesis 8 syndromes. While specific immunologic defects differ, a shared hallmark is atopic dermatitis (AD)–like eczema. We compared bacterial and fungal skin microbiomes (41 PID, 13 AD, 49 healthy controls) at four clinically relevant sites representing the major skin microenvironments. PID skin displayed increased ecological permissiveness with altered population structures, decreased site specificity and temporal stability, and colonization with microbial species not observed in controls, including Clostridium species and Serratia marcescens. Elevated fungal diversity and increased representation of opportunistic fungi (Candida, Aspergillus) supported increased PID skin permissiveness, suggesting that skin may serve as a reservoir for the recurrent fungal infections observed in these patients. The overarching theme of increased ecological permissiveness in PID skin was counterbalanced by the maintenance of a phylum barrier in which colonization remained restricted to typical human-associated phyla. Clinical parameters, including markers of disease severity, were positively correlated with prevalence of Staphylococcus, Corynebacterium, and other less abundant taxa. This study examines differences in microbial colonization and community stability in PID skin and informs our understanding of host–microbiome interactions, suggesting a bidirectional dialogue between skin commensals and the host organism. PMID:24170601

  14. The altered landscape of the human skin microbiome in patients with primary immunodeficiencies.

    PubMed

    Oh, Julia; Freeman, Alexandra F; Park, Morgan; Sokolic, Robert; Candotti, Fabio; Holland, Steven M; Segre, Julia A; Kong, Heidi H

    2013-12-01

    While landmark studies have shown that microbiota activate and educate host immunity, how immune systems shape microbiomes and contribute to disease is incompletely characterized. Primary immunodeficiency (PID) patients suffer recurrent microbial infections, providing a unique opportunity to address this issue. To investigate the potential influence of host immunity on the skin microbiome, we examined skin microbiomes in patients with rare monogenic PIDs: hyper-IgE (STAT3-deficient), Wiskott-Aldrich, and dedicator of cytokinesis 8 syndromes. While specific immunologic defects differ, a shared hallmark is atopic dermatitis (AD)-like eczema. We compared bacterial and fungal skin microbiomes (41 PID, 13 AD, 49 healthy controls) at four clinically relevant sites representing the major skin microenvironments. PID skin displayed increased ecological permissiveness with altered population structures, decreased site specificity and temporal stability, and colonization with microbial species not observed in controls, including Clostridium species and Serratia marcescens. Elevated fungal diversity and increased representation of opportunistic fungi (Candida, Aspergillus) supported increased PID skin permissiveness, suggesting that skin may serve as a reservoir for the recurrent fungal infections observed in these patients. The overarching theme of increased ecological permissiveness in PID skin was counterbalanced by the maintenance of a phylum barrier in which colonization remained restricted to typical human-associated phyla. Clinical parameters, including markers of disease severity, were positively correlated with prevalence of Staphylococcus, Corynebacterium, and other less abundant taxa. This study examines differences in microbial colonization and community stability in PID skin and informs our understanding of host-microbiome interactions, suggesting a bidirectional dialogue between skin commensals and the host organism.

  15. Immune dysregulation in primary immunodeficiency disorders.

    PubMed

    Torgerson, Troy R

    2008-05-01

    The past several years have brought an increased awareness of the prevalence of autoimmunity and immune dysregulation among patients who have primary immunodeficiency disorders (PIDD). The recent clinical and molecular definition of PIDD, in which the primary defect is in the immunoregulatory compartment of the immune system, has offered insight into the basic mechanisms of immune tolerance, which has provided new targets and new techniques to study immune tolerance in PIDD. Many of these studies have focused on the presence and function of regulatory T (T(REG)) cells in PIDD, particularly since the discovery of murine and human syndromes associated with T(REG) deficiency. This article focuses on the current state of knowledge regarding the role of T(REG) in various PIDD that have clinical features indicative of dysregulated immunity.

  16. Autoimmunity in Immunodeficiency

    PubMed Central

    Todoric, Krista; Koontz, Jessica B.; Mattox, Daniel; Tarrant, Teresa K.

    2013-01-01

    Primary immunodeficiencies (PID) comprise a diverse group of clinical disorders with varied genetic defects. Paradoxically, a substantial proportion of PID patients develop autoimmune phenomena in addition to having increased susceptibility to infections from their impaired immunity. Although much of our understanding comes from data gathered through experimental models, there are several well-characterized PID that have improved our knowledge of the pathways that drive autoimmunity. The goals of this review will be to discuss these immunodeficiencies and to review the literature with respect to the proposed mechanisms for autoimmunity within each put forth to date. PMID:23591608

  17. Unbalanced Immune System: Immunodeficiencies and Autoimmunity

    PubMed Central

    Giardino, Giuliana; Gallo, Vera; Prencipe, Rosaria; Gaudino, Giovanni; Romano, Roberta; De Cataldis, Marco; Lorello, Paola; Palamaro, Loredana; Di Giacomo, Chiara; Capalbo, Donatella; Cirillo, Emilia; D’Assante, Roberta; Pignata, Claudio

    2016-01-01

    Increased risk of developing autoimmune manifestations has been identified in different primary immunodeficiencies (PIDs). In such conditions, autoimmunity and immune deficiency represent intertwined phenomena that reflect inadequate immune function. Autoimmunity in PIDs may be caused by different mechanisms, including defects of tolerance to self-antigens and persistent stimulation as a result of the inability to eradicate antigens. This general immune dysregulation leads to compensatory and exaggerated chronic inflammatory responses that lead to tissue damage and autoimmunity. Each PID may be characterized by distinct, peculiar autoimmune manifestations. Moreover, different pathogenetic mechanisms may underlie autoimmunity in PID. In this review, the main autoimmune manifestations observed in different PID, including humoral immunodeficiencies, combined immunodeficiencies, and syndromes with immunodeficiencies, are summarized. When possible, the pathogenetic mechanism underlying autoimmunity in a specific PID has been explained. PMID:27766253

  18. A family history of serious complications due to BCG vaccination is a tool for the early diagnosis of severe primary immunodeficiency.

    PubMed

    Roxo-Junior, Pérsio; Silva, Jorgete; Andrea, Mauro; Oliveira, Larissa; Ramalho, Fernando; Bezerra, Thiago; Nunes, Altacílio A

    2013-09-10

    Severe Combined Immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency (PID). Complications of BCG vaccination, especially disseminated infection and its most severe forms, are known to occur in immunodeficient patients, particularly in SCID. A carefully taken family history before BCG injection as well as delaying vaccination if PID is suspected could be a simple and effective method to avoid inappropriate vaccination of an immunodeficient child in some cases until the prospect of newborn screening for SCID has been fully developed. We describe a patient with a very early diagnosis of SCID, which was suspected on the basis of the previous death of two siblings younger than one year due to severe complications secondary to the BCG vaccine. We suggest that a family history of severe or fatal reactions to BCG should be included as a warning sign for an early diagnosis of SCID.

  19. Acquired factor VIII deficiency associated with a novel primary immunodeficiency suggestive of autosomal recessive hyper IgE syndrome.

    PubMed

    Ozgur, Tuba Turul; Asal, Gulten Turkkan; Gurgey, Aytemiz; Tezcan, Ilhan; Ersoy, Fugen; Sanal, Ozden

    2007-05-01

    Primary immunodeficiency diseases (PID) are associated with various autoimmune complications and several manifestations of autoimmunity can be seen in the disorders of T cells, B cells, phagocytes, and complement components. Acquired hemophilia is a rare entity in childhood. Although autoantibodies may develop in various forms of PID, Factor VIII (FVIII) inhibitors have not been described before. Herein, we present a case of acquired hemophilia resulting from FVIII inhibitors who had underlying undefined PID features suggestive of autosomal recessive hyper IgE syndrome. Our patient responded to corticosteroid treatment rather well and quickly, with an increased FVIII level and decreased FVIII inhibitors. However, FVIII inhibitor reappeared 7 months later, and disappeared spontaneously 4 months ago. Long-term and close follow-up is needed to observe the long-term prognosis in this child.

  20. Modern management of primary T-cell immunodeficiencies.

    PubMed

    Pachlopnik Schmid, Jana; Güngör, Tayfun; Seger, Reinhard

    2014-06-01

    The study of human T-cell PIDs with Mendelian inheritance has enabled the molecular characterization of important key functions and pathways in T-cell biology. In most cases, T-cell PIDs become apparent as combined T- and B-cell deficiencies. Severe combined immunodeficiencies (SCIDs) are characterized by a complete lack of T-cell development and, in some cases, a developmental block in other lymphoid lineages and manifest within the first year of life. Combined immunodeficiency syndromes (CIDs) result from hypomorphic mutations in typical SCID associated genes or from partial defects of T-cell development and manifest later in childhood by increased susceptibility to infection often combined with disturbances in immune homeostasis, e.g., autoimmunity and increased incidence in lymphoproliferation. The discovery of mutations and characterization of the cellular changes that underlie lymphocyte defects and immune dysregulation have led to novel, specific, successful therapies for severe diseases which are often fatal if left untreated. Over the last few years, impressive progress has been made in understanding the disease mechanisms of T-cell immunodeficiencies and in improving the long-term outcomes of potentially curative treatments, including gene therapy.

  1. Primary immunodeficiencies and the control of Epstein-Barr virus infection.

    PubMed

    Palendira, Umaimainthan; Rickinson, Alan B

    2015-11-01

    Human primary immunodeficiency (PID) states, where mutations in single immune system genes predispose individuals to certain infectious agents and not others, are experiments of nature that hold important lessons for the immunologist. The number of genetically defined PIDs is rising rapidly, as is the opportunity to learn from them. Epstein-Barr virus (EBV), a human herpesvirus, has long been of interest because of its complex interaction with the immune system. Thus, it causes both infectious mononucleosis (IM), an immunopathologic disease associated with exaggerated host responses, and at least one malignancy, EBV-positive lymphoproliferative disease, when those responses are impaired. Here, we describe the full range of PIDs currently linked with an increased risk of EBV-associated disease. These provide examples where IM-like immunopathology is fatally exaggerated, and others where responses impaired at the stage of induction, expansion, or effector function predispose to malignancy. Current evidence from this rapidly moving field supports the view that lesions in both natural killer cell and T cell function can lead to EBV pathology.

  2. [Current status and future prospects of stem cell gene therapy for primary immunodeficiency].

    PubMed

    Uchiyama, Toru; Onodera, Masafumi

    2013-01-01

    Patients affected by primary immunodeficiency (PID) can be cured by allogeneic hematopoietic stem cell transplantation (HSCT). In the absence of HLA-matched donors, however, incidence of HSCT-related complications is observed. Therefore, gene therapy has been developed as a highly desirable alternative treatment for patients lacking suitable donors. Retrovirus-based gene therapy was begun in 1990 for the patients of adenosine deaminase deficiency, followed by X-linked severe combined immunodeficiency, Wiskott-Aldrich syndrome and chronic granulomatous disease. Although treated patients have had excellent immune reconstitution and resolution of ongoing infections, complications such as a lymphoproliferative syndrome and a disappearance of gene-modified cells were observed in some clinical trials. To overcome these, ongoing and upcoming clinical trials use some new strategies. The use of preconditioning chemotherapy makes space in the bone marrow for the gene-treated stem cells and allows engraftment of multi lineage stem/progenitor cells. Self-inactivating vectors in which strong enhancers of long terminal repeat are eliminated may reduce the risk of insertional activation of proto-oncogene resulting in leukemia. These modifications will surely increase the safety and efficacy of stem cell gene therapy for PID.

  3. Strategies for B-Cell Receptor Repertoire Analysis in Primary Immunodeficiencies: From Severe Combined Immunodeficiency to Common Variable Immunodeficiency

    PubMed Central

    IJspeert, Hanna; Wentink, Marjolein; van Zessen, David; Driessen, Gertjan J.; Dalm, Virgil A. S. H.; van Hagen, Martin P.; Pico-Knijnenburg, Ingrid; Simons, Erik J.; van Dongen, Jacques J. M.; Stubbs, Andrew P.; van der Burg, Mirjam

    2015-01-01

    The antigen receptor repertoires of B- and T-cells form the basis of the adaptive immune response. The repertoires should be sufficiently diverse to recognize all possible pathogens. However, careful selection is needed to prevent responses to self or harmless antigens. Limited antigen receptor repertoire diversity leads to immunodeficiency, whereas unselected or misdirected repertoires can result in autoimmunity. The antigen receptor repertoire harbors information about abnormalities in many immunological disorders. Recent developments in next generation sequencing allow the analysis of the antigen receptor repertoire in much greater detail than ever before. Analyzing the antigen receptor repertoire in patients with mutations in genes responsible for the generation of the antigen receptor repertoire will give new insights into repertoire formation and selection. In this perspective, we describe strategies and considerations for analysis of the naive and antigen-selected B-cell repertoires in primary immunodeficiency patients with a focus on severe combined immunodeficiency and common variable immunodeficiency. PMID:25904919

  4. Live rubella virus vaccine long-term persistence as an antigenic trigger of cutaneous granulomas in patients with primary immunodeficiency.

    PubMed

    Bodemer, C; Sauvage, V; Mahlaoui, N; Cheval, J; Couderc, T; Leclerc-Mercier, S; Debré, M; Pellier, I; Gagnieur, L; Fraitag, S; Fischer, A; Blanche, S; Lecuit, M; Eloit, M

    2014-10-01

    Granulomas may develop as a response to a local antigenic trigger, leading to the activation of macrophages and T-lymphocytes. Primary immunodeficiency (PID) is associated with the development of extensive cutaneous granulomas, whose aetiology remains unknown. We performed high-throughput sequencing of the transcriptome of cutaneous granuloma lesions on two consecutive index cases, and RT-PCR in a third consecutive patient. The RA27/3 vaccine strain of rubella virus-the core component of a universally used paediatric vaccine-was present in the cutaneous granuloma of these three consecutive PID patients. Controls included the healthy skin of two patients, non-granulomatous cutaneous lesions of patients with immunodeficiency, and skin biopsy samples of healthy individuals, and were negative. Expression of viral antigens was confirmed by immunofluorescence. Persistence of the rubella vaccine virus was also demonstrated in granuloma lesions sampled 4-5 years earlier. The persistence of the rubella virus vaccine strain in all three consecutive cutaneous granuloma patients with PID strongly suggests a causal relationship between rubella virus and granuloma in this setting.

  5. The CARD11-BCL10-MALT1 (CBM) signalosome complex: Stepping into the limelight of human primary immunodeficiency.

    PubMed

    Turvey, Stuart E; Durandy, Anne; Fischer, Alain; Fung, Shan-Yu; Geha, Raif S; Gewies, Andreas; Giese, Thomas; Greil, Johann; Keller, Bärbel; McKinnon, Margaret L; Neven, Bénédicte; Rozmus, Jacob; Ruland, Jürgen; Snow, Andrew L; Stepensky, Polina; Warnatz, Klaus

    2014-08-01

    Next-generation DNA sequencing has accelerated the genetic characterization of many human primary immunodeficiency diseases (PIDs). These discoveries can be lifesaving for the affected patients and also provide a unique opportunity to study the effect of specific genes on human immune function. In the past 18 months, a number of independent groups have begun to define novel PIDs caused by defects in the caspase recruitment domain family, member 11 (CARD11)-B-cell chronic lymphocytic leukemia/lymphoma 10 (BCL10)-mucosa-associated lymphoid tissue lymphoma translocation gene 1 (MALT1 [CBM]) signalosome complex. The CBM complex forms an essential molecular link between the triggering of cell-surface antigen receptors and nuclear factor κB activation. Germline mutations affecting the CBM complex are now recognized as the cause of novel combined immunodeficiency phenotypes, which all share abnormal nuclear factor κB activation and dysregulated B-cell development as defining features. For this "Current perspectives" article, we have engaged experts in both basic biology and clinical immunology to capture the worldwide experience in recognizing and managing patients with PIDs caused by CBM complex mutations.

  6. Human immunoglobulin 10 % with recombinant human hyaluronidase: replacement therapy in patients with primary immunodeficiency disorders.

    PubMed

    Sanford, Mark

    2014-08-01

    Human immunoglobulin is an established replacement therapy for patients with primary immunodeficiency disorders (PIDs). Recombinant human hyaluronidase (rHuPH20) is a spreading factor that temporarily digests hyaluronan in the skin interstitium enabling large volumes of fluid or drug solutions to be infused and absorbed subcutaneously. HyQvia® (IGHy) is a new combination product whereby rHuPH20 is injected subcutaneously, followed by human immunoglobulin 10 % infused through the same needle. Thus, IGHy can be administered at a reduced frequency compared with non-facilitated subcutaneous injection of human immunoglobulin, and with a lower frequency of infusion reactions than with intravenous administration. Home-based administration of IGHy is also feasible for adequately trained patients. IGHy was compared with intravenous human immunoglobulin 10 % in a non-randomized, open-label, phase 3 study in patients aged ≥2 years with PIDs who were receiving human immunoglobulin replacement therapy (n = 87). In this study, trough IgG concentrations, acute serious bacterial infection rates (primary endpoint) and occurrences of adverse events during the IGHy treatment period were generally similar to those observed during an intravenous treatment period. IGHy was associated with a numerically lower rate of systemic adverse events and a numerically higher rate of localized adverse events than those observed with intravenous treatment. Compared with intravenous administration, IGHy was administered at a significantly higher maximum flow rate and at a similar frequency. Most patients preferred IGHy over intravenous administration. IGHy offers a new method for subcutaneous delivery of human immunoglobulin replacement therapy in patients with PIDs.

  7. Primary immunodeficiency association with systemic lupus erythematosus: review of literature and lessons learned by the Rheumatology Division of a tertiary university hospital at São Paulo, Brazil.

    PubMed

    Errante, Paolo Ruggero; Perazzio, Sandro Félix; Frazão, Josias Brito; da Silva, Neusa Pereira; Andrade, Luis Eduardo Coelho

    2016-01-01

    Primary immunodeficiency disorders (PID) represent a heterogeneous group of diseases resulting from inherited defects in the development, maturation and normal function of immune cells; thus, turning individuals susceptible to recurrent infections, allergy, autoimmunity, and malignancies. In this retrospective study, autoimmune diseases (AIDs), in special systemic lupus erythematosus (SLE) which arose associated to the course of PID, are described. Classically, the literature describes three groups of PID associated with SLE: (1) deficiency of Complement pathway components, (2) defects in immunoglobulin synthesis, and (3) chronic granulomatous disease (CGD). Currently, other PID have been described with clinical manifestation of SLE, such as Wiskott-Aldrich syndrome (WAS), autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED), autoimmune lymphoproliferative syndrome (ALPS) and idiopathic CD4(+) lymphocytopenia. Also we present findings from an adult cohort from the outpatient clinic of the Rheumatology Division of Universidade Federal de São Paulo. The PID manifestations found by our study group were considered mild in terms of severity of infections and mortality in early life. Thus, it is possible that some immunodeficiency states are compatible with survival regarding infectious susceptibility; however these states might represent a strong predisposing factor for the development of immune disorders like those observed in SLE.

  8. Recent advances in treatment of severe primary immunodeficiencies

    PubMed Central

    Gennery, Andrew

    2015-01-01

    Primary immunodeficiencies are rare, inborn errors that result in impaired, disordered or uncontrolled immune responses. Whilst symptomatic and prophylactic treatment is available, hematopoietic stem cell transplantation is an option for many diseases, leading to cure of the immunodeficiency and establishing normal physical and psychological health. Newborn screening for some diseases, whilst improving outcomes, is focusing research on safer and less toxic treatment strategies, which result in durable and sustainable immune function without adverse effects. New conditioning regimens have reduced the risk of hematopoietic stem cell transplantation, and new methods of manipulating stem cell sources should guarantee a donor for almost all patients. Whilst incremental enhancements in transplantation technique have gradually improved survival outcomes over time, some of these new applications are likely to radically alter our approach to treating primary immunodeficiencies. PMID:26918153

  9. Cancers Related to Immunodeficiencies: Update and Perspectives

    PubMed Central

    Mortaz, Esmaeil; Tabarsi, Payam; Mansouri, Davod; Khosravi, Adnan; Garssen, Johan; Velayati, Aliakbar; Adcock, Ian M.

    2016-01-01

    The life span of patients with primary and secondary immunodeficiency is increasing due to recent improvements in therapeutic strategies. While the incidence of primary immunodeficiencies (PIDs) is 1:10,000 births, that of secondary immunodeficiencies are more common and are associated with posttransplantation immune dysfunction, with immunosuppressive medication for human immunodeficiency virus or with human T-cell lymphotropic virus infection. After infection, malignancy is the most prevalent cause of death in both children and adults with (PIDs). PIDs more often associated with cancer include common variable immunodeficiency (CVID), Wiskott–Aldrich syndrome, ataxia-telangiectasia, and severe combined immunodeficiency. This suggests that a protective immune response against both infectious non-self-(pathogens) and malignant self-challenges (cancer) exists. The increased incidence of cancer has been attributed to defective elimination of altered or “transformed” cells and/or defective immunity towards cancer cells. The concept of aberrant immune surveillance occurring in PIDs is supported by evidence in mice and from patients undergoing immunosuppression after transplantation. Here, we discuss the importance of PID defects in the development of malignancies and the current limitations associated with molecular pathogenesis of these diseases and emphasize the need for further knowledge of how specific mutations can modulate the immune system to alter immunosurveillance and thereby play a key role in the etiology of malignancies in PID patients. PMID:27703456

  10. Primary immunodeficiencies appearing as combined lymphopenia, neutropenia, and monocytopenia.

    PubMed

    Dotta, Laura; Badolato, Raffaele

    2014-10-01

    Recurrent or prolonged severe infections associated to panleukopenia strongly suggest primary immune disorders. In recent years, new immunodeficiency syndromes turned up: besides the importance of continuous clinical characterization throughout added reports, the phenotype can easily lead to diagnosis of known rare entities. Our purpose is to review main emerging genetic syndromes featuring lymphopenia combined to neutropenia and/or monocytopenia in order to facilitate diagnosis of rare primary immune deficiencies.

  11. Respiratory syncytial virus infections in infants affected by primary immunodeficiency.

    PubMed

    Lanari, Marcello; Vandini, Silvia; Capretti, Maria Grazia; Lazzarotto, Tiziana; Faldella, Giacomo

    2014-01-01

    Primary immunodeficiencies are rare inherited disorders that may lead to frequent and often severe acute respiratory infections. Respiratory syncytial virus (RSV) is one of the most frequent pathogens during early infancy and the infection is more severe in immunocompromised infants than in healthy infants, as a result of impaired T- and B-cell immune response unable to efficaciously neutralize viral replication, with subsequent increased viral shedding and potentially lethal lower respiratory tract infection. Several authors have reported a severe clinical course after RSV infections in infants and children with primary and acquired immunodeficiencies. Environmental prophylaxis is essential in order to reduce the infection during the epidemic season in hospitalized immunocompromised infants. Prophylaxis with palivizumab, a humanized monoclonal antibody against the RSV F protein, is currently recommended in high-risk infants born prematurely, with chronic lung disease or congenital heart disease. Currently however the prophylaxis is not routinely recommended in infants with primary immunodeficiency, although some authors propose the extension of prophylaxis to this high risk population.

  12. What is the status of gene therapy for primary immunodeficiency?

    PubMed

    Blaese, R Michael

    2007-01-01

    The efforts to find satisfactory treatments for seriously ill patients with primary immunodeficiency have resulted in the development of important new therapeutic procedures with benefits reaching far beyond the relatively small number of patients affected with these rare disorders. Allogeneic bone marrow transplantation, immunoglobulin and enzyme replacement treatments and more recently gene therapy have all been introduced into clinical medicine as treatments for one or more of the primary immunodeficiency diseases. Beginning in 1990, gene-corrected T cells were first used to treat ADA deficiency SCID. With this demonstration that the gene-transfer procedure could be safely used to introduce functional transgenes into patient cells, clinical trials for a broad range of inherited disorders and cancer were started in the mid 90s. Of all these early clinical experiments, those addressing primary immunodeficiency have also been the most successful. Both ADA and X-SCID have now been cured using gene insertion into autologous bone marrow stem cells. In addition some patients with chronic granulomatous disease (CGD) have shown an unexpectedly high level of functionally corrected granulocytes in their blood following infusion of autologous gene-corrected bone marrow. There remain however a great many significant challenges to be overcome before gene therapy becomes the treatment of choice for these and other disorders. The use of genes as medicines is the most complex therapeutic system ever attempted and it may rake several more decades of work before its real potential as a treatment for both inherited and sporadic disorders if finally realized.

  13. Respiratory Syncytial Virus Infections in Infants Affected by Primary Immunodeficiency

    PubMed Central

    Capretti, Maria Grazia; Lazzarotto, Tiziana; Faldella, Giacomo

    2014-01-01

    Primary immunodeficiencies are rare inherited disorders that may lead to frequent and often severe acute respiratory infections. Respiratory syncytial virus (RSV) is one of the most frequent pathogens during early infancy and the infection is more severe in immunocompromised infants than in healthy infants, as a result of impaired T- and B-cell immune response unable to efficaciously neutralize viral replication, with subsequent increased viral shedding and potentially lethal lower respiratory tract infection. Several authors have reported a severe clinical course after RSV infections in infants and children with primary and acquired immunodeficiencies. Environmental prophylaxis is essential in order to reduce the infection during the epidemic season in hospitalized immunocompromised infants. Prophylaxis with palivizumab, a humanized monoclonal antibody against the RSV F protein, is currently recommended in high-risk infants born prematurely, with chronic lung disease or congenital heart disease. Currently however the prophylaxis is not routinely recommended in infants with primary immunodeficiency, although some authors propose the extension of prophylaxis to this high risk population. PMID:25089282

  14. Hyaluronidase facilitated subcutaneous immunoglobulin in primary immunodeficiency

    PubMed Central

    Jolles, Stephen

    2013-01-01

    Immunoglobulin (Ig)-replacement therapy represents the mainstay of treatment for patients with primary antibody deficiency and is administered either intravenously (IVIg) or subcutaneously (SCIg). While hyaluronidase has been used in clinical practice for over 50 years, the development of a high-purity recombinant form of this enzyme (recombinant human hyaluronidase PH20) has recently enabled the study of repeated and more prolonged use of hyaluronidase in facilitating the delivery of SC medicines. It has been used in a wide range of clinical settings to give antibiotics, local anesthetics, insulin, morphine, fluid replacement, and larger molecules, such as antibodies. Hyaluronidase has been used to help overcome the limitations on the maximum volume that can be delivered into the SC space by enabling dispersion of SCIg and its absorption into lymphatics. The rate of facilitated SCIg (fSCIg) infusion is equivalent to that of IVIg, and the volume administered at a single site can be greater than 700 mL, a huge increase over conventional SCIg, at 20–40 mL. The use of fSCIg avoids the higher incidence of systemic side effects of IVIg, and it has higher bioavailability than SCIg. Data on the long-term safety of this approach are currently lacking, as fSCIg has only recently become available. fSCIg may help several areas of patient management in primary antibody deficiency, and the extent to which it may be used in future will depend on long-term safety data and cost–benefit analysis. PMID:27471693

  15. Primary Immunodeficiency Diseases: An Update on the Classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency

    PubMed Central

    Al-Herz, Waleed; Bousfiha, Aziz; Casanova, Jean-Laurent; Chapel, Helen; Conley, Mary Ellen; Cunningham-Rundles, Charlotte; Etzioni, Amos; Fischer, Alain; Franco, Jose Luis; Geha, Raif S.; Hammarström, Lennart; Nonoyama, Shigeaki; Notarangelo, Luigi Daniele; Ochs, Hans Dieter; Puck, Jennifer M.; Roifman, Chaim M.; Seger, Reinhard; Tang, Mimi L. K.

    2011-01-01

    We report the updated classification of primary immunodeficiency diseases, compiled by the ad hoc Expert Committee of the International Union of Immunological Societies. As compared to the previous edition, more than 15 novel disease entities have been added in the updated version. For each disorders, the key clinical and laboratory features are provided. This updated classification is meant to help in the diagnostic approach to patients with these diseases. PMID:22566844

  16. XMEN disease: a new primary immunodeficiency affecting Mg2+ regulation of immunity against Epstein-Barr virus

    PubMed Central

    Li, Feng-Yen; Chaigne-Delalande, Benjamin; Su, Helen; Uzel, Gulbu; Matthews, Helen

    2014-01-01

    Epstein-Barr virus (EBV) is an oncogenic gammaherpesvirus that infects and persists in 95% of adults worldwide and has the potential to cause fatal disease, especially lymphoma, in immunocompromised hosts. Primary immunodeficiencies (PIDs) that predispose to EBV-associated malignancies have provided novel insights into the molecular mechanisms of immune defense against EBV. We have recently characterized a novel PID now named “X-linked immunodeficiency with magnesium defect, EBV infection, and neoplasia” (XMEN) disease characterized by loss-of-function mutations in the gene encoding magnesium transporter 1 (MAGT1), chronic high-level EBV with increased EBV-infected B cells, and heightened susceptibility to EBV-associated lymphomas. The genetic etiology of XMEN disease has revealed an unexpected quantitative role for intracellular free magnesium in immune functions and has led to novel diagnostic and therapeutic strategies. Here, we review the clinical presentation, genetic mutation spectrum, molecular mechanisms of pathogenesis, and diagnostic and therapeutic considerations for this previously unrecognized disease. PMID:24550228

  17. Immune globulin subcutaneous (human) 20%: in primary immunodeficiency disorders.

    PubMed

    McCormack, Paul L

    2012-05-28

    Immune globulin subcutaneous 20% is a new high-concentration (200 g/L) solution of highly purified human IgG (≥98%) indicated in the EU and the US for antibody replacement therapy in patients with primary immunodeficiency with antibody deficiency, and in the EU for replacement therapy in humoral immunodeficiency secondary to myeloma or chronic lymphocytic leukaemia. Immune globulin subcutaneous 20% is formulated with L-proline, which imparts long-term stability at room temperature and a relatively low viscosity. In two pivotal phase III trials in stably treated patients with primary immunodeficiency, immune globulin subcutaneous 20% at weekly subcutaneous dosages either equivalent to each patient's previous intravenous or subcutaneous replacement therapy, or providing equivalent systemic exposure to previous intravenous therapy, produced mean serum IgG trough levels equal to or greater than pre-study levels. In each trial, there were no serious bacterial infections during treatment throughout the 28-week or 12-month efficacy periods. The rates of infectious episodes, days missed from work/school, days hospitalized or days with antibiotics were low. Immune globulin subcutaneous 20% was generally well tolerated. A high proportion of patients experienced local infusion-site reactions, but infusion-related systemic adverse events were relatively infrequent. Most adverse events were of mild or moderate intensity and did not interfere with therapy.

  18. 7th International Immunoglobulin Conference: Immunodeficiencies

    PubMed Central

    Schmidt, R E; Ochs, H D

    2014-01-01

    Awareness of the challenges involved in diagnosing and treating a heterogeneous group of immunodeficiency disorders is growing. The improvements in neonatal screening offer new methods to ensure that primary immunodeficiencies (PIDs) are diagnosed as early as possible, enabling accurate treatment and the prevention of life-threatening infections and other complications. Additionally, the need to individualize patient therapy in order to optimize both clinical outcomes and quality-of-life is obvious and is exemplified by the ability to switch between intravenous and subcutaneous immunoglobulin administration offering flexible treatment regimens. However, further research is crucial in order to determine the optimal treatment for secondary immunodeficiencies, and to gain greater understanding of the underlying causes of PIDs, including common variable immunodeficiency. The information relating to the growth of patient registries is encouraging, with approximately 25 000 patients with PIDs included in the two registries discussed. Registries such as this are vital for future research, as well as providing an educational resource. PMID:25546748

  19. Primary Care of the Human Immunodeficiency Virus Patient.

    PubMed

    Buckhold, Fred R

    2015-09-01

    Human immunodeficiency virus (HIV) is a disease that affects 1 million patients in the United States. Many excellent drug regimens exist that effectively suppress the viral load and improve immune function, but there are consequences of long-term antiviral therapy. In addition, patients with HIV tend to have much higher rates of chronic disease, substance abuse, and cancer. Thus, while expert care in the treatment of HIV remains critical, the skill set of a primary care provider in the prevention, detection, and management of acute and chronic illness is vital to the care of the HIV patient.

  20. Primary pulmonary hypertension associated with human immunodeficiency virus infection.

    PubMed Central

    Golpe, R.; Fernandez-Infante, B.; Fernandez-Rozas, S.

    1998-01-01

    Several cardiorespiratory diseases can complicate human immunodeficiency virus infection. Primary pulmonary hypertension is a rare clinical disorder which carries a bad prognosis. More than 90 cases of HIV-associated primary pulmonary hypertension have been reported to date. Although its pathogenesis remains unknown, some evidence suggests a possible role for the virus itself in its development. Genetic susceptibility may also be implicated. The clinical and histopathologic features of this entity do not differ from those of classic primary pulmonary hypertension. The diagnosis requires a high degree of clinical suspicion and a careful evaluation to rule out causes of secondary pulmonary hypertension. In addition to supportive measures, anticoagulation and vasodilators have been used to treat this disorder, although sufficient data regarding long-term results with these therapies are lacking. PMID:9799910

  1. Primary pulmonary hypertension associated with human immunodeficiency virus infection.

    PubMed

    Golpe, R; Fernandez-Infante, B; Fernandez-Rozas, S

    1998-07-01

    Several cardiorespiratory diseases can complicate human immunodeficiency virus infection. Primary pulmonary hypertension is a rare clinical disorder which carries a bad prognosis. More than 90 cases of HIV-associated primary pulmonary hypertension have been reported to date. Although its pathogenesis remains unknown, some evidence suggests a possible role for the virus itself in its development. Genetic susceptibility may also be implicated. The clinical and histopathologic features of this entity do not differ from those of classic primary pulmonary hypertension. The diagnosis requires a high degree of clinical suspicion and a careful evaluation to rule out causes of secondary pulmonary hypertension. In addition to supportive measures, anticoagulation and vasodilators have been used to treat this disorder, although sufficient data regarding long-term results with these therapies are lacking.

  2. 7th International Immunoglobulin Conference: Immunodeficiencies

    PubMed Central

    Schmidt, R E; Ochs, H D

    2014-01-01

    Most primary immunodeficiency disorders (PID) are the result of single gene defects. Based on this fact, more than 240 different entities have been identified. Those PIDs with predominant antibody deficiency are treated with immunoglobulin (Ig) replacement therapy. This review focuses on the diagnosis, clinical characteristics and treatment of patients suffering from PID, or secondary immunodeficiency disorders (SID) caused, for instance, by irradiation, immunosuppressive drugs or thymectomy. Common variable immunodeficiency (CVID) is the most commonly diagnosed and least understood form of PID, with a heterogeneous range of symptoms and genotypes, requiring individualized treatment plans. This includes adjusting the dose and treatment interval, administrating Ig by intravenous or subcutaneous injection by either pump or push, and finally deciding which treatment options are best for a given patient. Ig therapy can also be used to treat immunodeficiencies resulting from lymphoproliferative and autoimmune diseases or immunosuppression following organ transplantation; however, there is an urgent need for research in this field. Accurate and early diagnosis of PID is important to ensure that optimal treatment is started early to maintain the patient's health. Detailed patient registries have been established to increase awareness of PID, as well as provide a valuable resource for further research. PMID:25546741

  3. [Serratia infections, should we think about primary immunodeficiencies?

    PubMed

    Montaner Ramón, Alicia; Murillo Sanjuán, Laura; Martínez Faci, Cristina; Guerrero Laleona, Carmelo; Rodríguez-Vigil Iturrate, Carmen

    2017-04-01

    Chronic granulomatous disease (CGD) is a primary immunodeficiency with an incidence of 1/200,000-250,000 live births. CGD affects mainly male patients, most of the mutations being X-linked, and autosomal recessive forms occur more frequently in communities with greater numbers of consanguineous marriages. CGD is characterized by sensitivity to recurrent and severe bacterial and fungal infections, with formation of granulomas due to the inability of phagocytes to generate reactive oxygen compounds, necessary for the intracellular death of phagocytic microorganisms. We report three cases of CGD in which Serratia marcescens was isolated, and after detailed anamnesis and performance of neutrophil function tests, a molecular diagnosis of the disease was reached. CGD can be manifested in a wide variety of ways, so that high suspicion and a meticulous anamnesis are essential to reach a diagnosis.

  4. Gene therapy for primary immunodeficiencies: current status and future prospects.

    PubMed

    Qasim, Waseem; Gennery, Andrew R

    2014-06-01

    Gene therapy using autologous haematopoietic stem cells offers a valuable treatment option for patients with primary immunodeficiencies who do not have access to an HLA-matched donor, although such treatments have not been without their problems. This review details gene therapy trials for X-linked and adenosine deaminase (ADA)-deficient severe combined immunodeficiency (SCID), Wiskott-Aldrich syndrome (WAS) and chronic granulomatous disease (CGD). X-linked SCID was chosen for gene therapy because of previous 'natural' genetic correction through a reversion event in a single lymphoid precursor, demonstrating limited thymopoiesis and restricted T-lymphocyte receptor repertoire, showing selective advantage of progenitors possessing the wild-type gene. In early studies, patients were treated with long terminal repeats-intact gamma-retroviral vectors, without additional chemotherapy. Early results demonstrated gene-transduced cells, sustained thymopoiesis, and a diverse T-lymphocyte repertoire with normal function. Serious adverse effects were subsequently reported in 5 of 20 patients, with T-lymphocyte leukaemia developing, secondary to the viral vector integrating adjacent to a known oncogene. New trials using self-inactivating gamma-retroviral vectors are progressing. Trials for ADA-SCID using gamma-retroviral vectors have been successful, with no similar serious adverse effects reported; trials using lentiviral vectors are in progress. Patients with WAS and CGD treated with early gamma-retroviral vectors have developed similar lymphoproliferative adverse effects to those seen in X-SCID--current trials are using new-generation vectors. Targeted gene insertion using homologous recombination of corrected gene sequences by cellular DNA repair pathways following targeted DNA breakage will improve efficacy and safety of gene therapy. A number of new techniques are discussed.

  5. Medical awareness concerning primary immunodeficiency diseases in the city of São Paulo, Brazil

    PubMed Central

    Dantas, Ellen de Oliveira; Aranda, Carolina Sanchez; Nobre, Fernanda Aimée; Fahl, Kristine; Mazzucchelli, Juliana Themudo Lessa; Felix, Erika; Nero, Dora Lisa Friedlander-Del; Nudelman, Victor; Sano, Flavio; Condino-Neto, Antonio; Damasceno, Elaine; Costa-Carvalho, Beatriz Tavares

    2013-01-01

    ABSTRACT Objective: To evaluate medical knowledge of primary immunodeficiency in the city of Sao Paulo (SP). Methods: A 14-item questionnaire about primary immunodeficiency was applied to physicians who worked at general hospitals. One of the questions presented 25 clinical situations that could be associated or not with primary immunodeficiency, and the percentage of appropriate answers generated a knowledge indicator. Results: Seven hundred and forty-six participated in the study, among them 215 pediatricians (28.8%), 244 surgeons (32.7%), and 287 clinicians (38.5%). About 70% of the physicians responded that they had learned about primary immunodeficiency in graduate school or in residency training. Treatment of patients that use antibiotics frequently was reported by 75% dos physicians, but only 34.1% had already investigated a patient and 77.8% said they did not know the ten warning signs for primary immunodeficiency. The knowledge indicator obtained showed a mean of 45.72% (±17.87). Only 26.6% if the pediatricians and 6.6% of clinicians and surgeons showed a knowledge indicator of at least 67% (equivalent to an appropriate answer in two thirds of the clinical situations). Conclusion: There is a deficit in medical knowledge of primary immunodeficiency in the city of Sao Paulo, even among pediatricians, despite having greater contact with the theme over the last few years. The improvement of information on primary immunodeficiency in the medical community is an important step towards the diagnosis and treatment process of these diseases. PMID:24488388

  6. Allogeneic Bone Marrow Transplantation in Patients With Primary Immunodeficiencies

    ClinicalTrials.gov

    2009-10-14

    Immunologic Deficiency Syndromes; Chediak-Higashi Syndrome; Common Variable Immunodeficiency; Graft Versus Host Disease; X-Linked Lymphoproliferative Syndrome; Familial Erythrophagocytic Lymphohistiocytosis; Hemophagocytic Lymphohistiocytosis; X-linked Agammaglobulinemia; Wiskott-Aldrich Syndrome; Chronic Granulomatous Disease; X-linked Hyper IgM Syndrome; Severe Combined Immunodeficiency; Leukocyte Adhesion Deficiency Syndrome; Virus-Associated Hemophagocytic Syndrome

  7. Vaccine-Derived Polioviruses and Children with Primary Immunodeficiency, Iran, 1995–2014

    PubMed Central

    Shaghaghi, Mohammadreza; Shahmahmoodi, Shohreh; Abolhassani, Hassan; Soleyman-jahi, Saeed; Parvaneh, Leila; Mahmoudi, Sussan; Chavoshzadeh, Zahra; Yazdani, Reza; Zahraei, Seyed Mohsen; Ebrahimi, Mohsen; Eslamian, Mohammad H.; Tabatabaie, Hamideh; Yousefi, Maryam; Kandelousi, Yaghoob M.; Oujaghlou, Aliasghar; Rezaei, Nima

    2016-01-01

    Widespread use of oral poliovirus vaccine has led to an ≈99.9% decrease in global incidence of poliomyelitis (from ≈350,000 cases in 1988 to 74 cases in 2015) and eradication of wild-type poliovirus serotypes 2 and 3. However, patients with primary immunodeficiency might shed vaccine-derived polioviruses (VDPVs) for an extended period, which could pose a major threat to polio eradication programs. Since 1995, sixteen VDPV populations have been isolated from 14 patients with immunodeficiency in Iran. For these patients, vaccine-associated paralysis, mostly in >1 extremity, was the first manifestation of primary immunodeficiency. Seven patients with humoral immunodeficiency cleared VDPV infection more frequently than did 6 patients with combined immunodeficiencies. Our results raise questions about manifestations of VDPVs in immunodeficient patients and the role of cellular immunity against enterovirus infections. On the basis of an association between VDPVs and immunodeficiency, we advocate screening of patients with primary immunodeficiency for shedding of polioviruses. PMID:27648512

  8. [Hematopoietic stem cell transplant in combined immunodeficiency syndromes of childhood: an optimal treatment for primary immunodeficiency].

    PubMed

    Olaya-Vargas, Alberto; Coronel-Moran, Rocío; Rivera-Luna, Roberto; Bravo-Lindoro, Amalia; Bejar-Ramírez, Yadira; Lormendez-Jacome, Doris

    2005-01-01

    The congenital immunodeficiency disorders in which the defect has been clearly traced to the stem cell can be cured with allogeneic stem-cell transplantation (SCT) from an unaffected donor. Widespread application of this treatment modality has been tempered by the fact that risk-benefit considerations do not always favor a procedure that carries a significant risk for morbidity and mortality. Some malignant disorders of childhood eventually have to be treated by an autologous or allogeneic SCT, however nonmalignant disorders can also be treated with this approach. This article reviews the current status of SCT for nonmalignant inherited immunodeficiency disorders.

  9. Diagnosis and treatment of gastrointestinal disorders in patients with primary immunodeficiency.

    PubMed

    Agarwal, Shradha; Mayer, Lloyd

    2013-09-01

    Gastrointestinal disorders such as chronic or acute diarrhea, malabsorption, abdominal pain, and inflammatory bowel diseases can indicate immune deficiency. The gastrointestinal tract is the largest lymphoid organ in the body, so it is not surprising that intestinal diseases are common among immunodeficient patients. Gastroenterologists therefore must be able to diagnose and treat patients with primary immunodeficiency. Immune-related gastrointestinal diseases can be classified as those that develop primarily via autoimmunity, infection, an inflammatory response, or malignancy. Immunodeficient and immunocompetent patients with gastrointestinal diseases present with similar symptoms. However, intestinal biopsy specimens from immunodeficient patients often have distinct histologic features, and these patients often fail to respond to conventional therapies. Therefore, early recognition of symptoms and referral to an immunologist for a basic immune evaluation is required to select appropriate treatments. Therapies for primary immunodeficiency comprise immunoglobulin replacement, antibiotics, and, in severe cases, bone marrow transplantation. Treatment of immunodeficient patients with concomitant gastrointestinal disease can be challenging, and therapy with immunomodulators often is required for severe disease. This review aims to guide gastroenterologists in the diagnosis and treatment of patients with primary immunodeficiency.

  10. New frontiers in the therapy of primary immunodeficiency: From gene addition to gene editing.

    PubMed

    Kohn, Donald B; Kuo, Caroline Y

    2017-03-01

    The most severe primary immune deficiency diseases (PIDs) have been successfully treated with allogeneic hematopoietic stem cell transplantation for more than 4 decades. However, such transplantations have the best outcomes when there is a well-matched donor available because immune complications, such as graft-versus-host disease, are greater without a matched sibling donor. Gene therapy has been developed as a method to perform autologous transplantations of a patient's own stem cells that are genetically corrected. Through an iterative bench-to-bedside-and-back process, methods to efficiently add new copies of the relevant gene to hematopoietic stem cells have led to safe and effective treatments for several PIDs, including forms of severe combined immune deficiency, Wiskott-Aldrich syndrome, and chronic granulomatous disease. New methods for gene editing might allow additional PIDs to be treated by gene therapy because they will allow the endogenous gene to be repaired and expressed under its native regulatory elements, which are essential for genes involved in cell processes of signaling, activation, and proliferation. Gene therapy is providing exciting new treatment options for patients with PIDs, and advances are sure to continue.

  11. A Phenotypic Approach for IUIS PID Classification and Diagnosis: Guidelines for Clinicians at the Bedside

    PubMed Central

    Jeddane, Leïla; Ailal, Fatima; Al Herz, Waleed; Conley, Mary Ellen; Cunningham-Rundles, Charlotte; Etzioni, Amos; Fischer, Alain; Franco, Jose Luis; Geha, Raif S.; Hammarström, Lennart; Nonoyama, Shigeaki; Ochs, Hans D.; Roifman, Chaim M.; Seger, Reinhard; Tang, Mimi L. K.; Puck, Jennifer M.; Chapel, Helen; Notarangelo, Luigi D.; Casanova, Jean-Laurent

    2014-01-01

    The number of genetically defined Primary Immunodeficiency Diseases (PID) has increased exponentially, especially in the past decade. The biennial classification published by the IUIS PID expert committee is therefore quickly expanding, providing valuable information regarding the disease-causing genotypes, the immunological anomalies, and the associated clinical features of PIDs. These are grouped in eight, somewhat overlapping, categories of immune dysfunction. However, based on this immunological classification, the diagnosis of a specific PID from the clinician’s observation of an individual clinical and/or immunological phenotype remains difficult, especially for non-PID specialists. The purpose of this work is to suggest a phenotypic classification that forms the basis for diagnostic trees, leading the physician to particular groups of PIDs, starting from clinical features and combining routine immunological investigations along the way.We present 8 colored diagnostic figures that correspond to the 8 PID groups in the IUIS Classification, including all the PIDs cited in the 2011 update of the IUIS classification and most of those reported since. PMID:23657403

  12. The plethora, clinical manifestations and treatment options of autoimmunity in patients with primary immunodeficiency

    PubMed Central

    Barış, Hatice Ezgi; Kıykım, Ayça; Nain, Ercan; Özen, Ahmet Oğuzhan; Karakoç-Aydıner, Elif; Barış, Safa

    2016-01-01

    Aim Although the association between primary immunodeficiency and autoimmunity is already well-known, it has once again become a topic of debate with the discovery of newly-defined immunodeficiencies. Thus, investigation of the mechanisms of development of autoimmunity in primary immunodefficiency and new target-specific therapeutic options has come to the fore. In this study, we aimed to examine the clinical findings of autoimmunity, autoimmunity varieties, and treatment responses in patients who were genetically diagnosed as having primary immunodeficiency. Material and Methods The files of patients with primary immunodeficiency who had clinical findings of autoimmunity, who were diagnosed genetically, and followed up in our clinic were investigated. The demographic and clinical features of the patients and their medical treatments were evaluated. Results Findings of autoimmunity were found in 30 patients whose genetic mutations were identified. The mean age at the time of the first symptoms was 8.96±14.64 months, and the mean age of receiving a genetic diagnosis was 82.55±84.71 months. The most common diseases showing findings of autoimmunity included immune dysregulation, polyendocrinopathy, enteropathy X-linked syndrome (16.7%); autoimmune lymphoproliferative syndrome (10%); lipopolysaccharide-responsive beige-like anchor protein deficiency (10%); and DiGeorge syndrome (10%). Twelve (40%) patients showed findings of autoimmunity at the time of first presentation. The most common findings of autoimmunity included inflammatory bowel disease, inflammatory bowel disease-like findings (n=14, 46.7%), immune thrombocytopenic purpura (n=11, 36.7%), and autoimmune hemolytic anemia (n=9, 30.0%). A response to immunosupressive agents was observed in 15 (50%) patients. Ten patients underwent hematopoietic stem cell transplantation. Six patients were lost to follow-up due to a variety of complications. Conclusion Autoimmunity is frequently observed in patients with

  13. Primary immunodeficiency diseases in Latin America: the second report of the LAGID registry.

    PubMed

    Leiva, Lily E; Zelazco, Marta; Oleastro, Matías; Carneiro-Sampaio, Magda; Condino-Neto, Antonio; Costa-Carvalho, Beatriz Tavares; Grumach, Anete Sevciovic; Quezada, Arnoldo; Patiño, Pablo; Franco, José Luis; Porras, Oscar; Rodríguez, Francisco Javier; Espinosa-Rosales, Francisco Javier; Espinosa-Padilla, Sara Elva; Almillategui, Diva; Martínez, Celia; Tafur, Juan Rodríguez; Valentín, Marilyn; Benarroch, Lorena; Barroso, Rosy; Sorensen, Ricardo U

    2007-01-01

    This is the second report on the continuing efforts of LAGID to increase the recognition and registration of patients with primary immunodeficiency diseases in 12 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Honduras, Mexico, Panama, Paraguay, Peru, Uruguay, and Venezuela. This report reveals that from a total of 3321 patients registered, the most common form of primary immunodeficiency disease was predominantly antibody deficiency (53.2%) with IgA deficiency reported as the most frequent phenotype. This category was followed by 22.6% other well-defined ID syndromes, 9.5% combined T- and B-cell inmunodeficiency, 8.6% phagocytic disorders, 3.3% diseases of immune dysregulation, and 2.8% complement deficiencies. All countries that participated in the first publication in 1998 reported an increase in registered primary immunodeficiency cases, ranging between 10 and 80%. A comparison of the estimated minimal incidence of X-linked agammaglobulinemia, chronic granulomatous disease, and severe combined immunodeficiency between the first report and the present one shows an increase in the reporting of these diseases in all countries. In this report, the estimated minimal incidence of chronic granulomatous disease was between 0.72 and 1.26 cases per 100,000 births in Argentina, Chile, Costa Rica, and Uruguay and the incidence of severe combined immunodeficiency was 1.28 and 3.79 per 100,000 births in Chile and Costa Rica, respectively. However, these diseases are underreported in other participating countries. In addition to a better diagnosis of primary immunodeficiency diseases, more work on improving the registration of patients by each participating country and by countries that have not yet joined LAGID is still needed.

  14. Modeling strategy to identify patients with primary immunodeficiency utilizing risk management and outcome measurement.

    PubMed

    Modell, Vicki; Quinn, Jessica; Ginsberg, Grant; Gladue, Ron; Orange, Jordan; Modell, Fred

    2017-02-21

    This study seeks to generate analytic insights into risk management and probability of an identifiable primary immunodeficiency defect. The Jeffrey Modell Centers Network database, Jeffrey Modell Foundation's 10 Warning Signs, the 4 Stages of Testing Algorithm, physician-reported clinical outcomes, programs of physician education and public awareness, the SPIRIT® Analyzer, and newborn screening, taken together, generates P values of less than 0.05%. This indicates that the data results do not occur by chance, and that there is a better than 95% probability that the data are valid. The objectives are to improve patients' quality of life, while generating significant reduction of costs. The advances of the world's experts aligned with these JMF programs can generate analytic insights as to risk management and probability of an identifiable primary immunodeficiency defect. This strategy reduces the uncertainties related to primary immunodeficiency risks, as we can screen, test, identify, and treat undiagnosed patients. We can also address regional differences and prevalence, age, gender, treatment modalities, and sites of care, as well as economic benefits. These tools support high net benefits, substantial financial savings, and significant reduction of costs. All stakeholders, including patients, clinicians, pharmaceutical companies, third party payers, and government healthcare agencies, must address the earliest possible precise diagnosis, appropriate intervention and treatment, as well as stringent control of healthcare costs through risk assessment and outcome measurement. An affected patient is entitled to nothing less, and stakeholders are responsible to utilize tools currently available. Implementation offers a significant challenge to the entire primary immunodeficiency community.

  15. Surface markers on human lymphocytes: studies of normal subjects and of patients with primary immunodeficiencies

    PubMed Central

    Aiuti, F.; Lacava, V.; Garofalo, J. A.; D'Amelio, R.; D'Asero, C.

    1973-01-01

    Peripheral blood lymphocytes of twenty normal controls and twelve patients with primary immunodeficiencies were examined for surface membrane Ig and receptors for C3 complement (B cell markers) and for spontaneous rosette formation with sheep erythrocytes (T cell markers). In patients with defects in T cell function no lymphocytes forming spontaneous rosettes were seen. In patients with B cell deficiency they were normal or increased. Lymphocytes with membrane immunoglobulins were normal in patients with T cell defect and absent in patients with severe agammaglobulinaemia. Lymphocytes with receptors for C3 complement were increased in patients with T defect and normal in patients with most other forms of immunodeficiency studied. PMID:4587827

  16. [Primary hepatic lymphoma in subjects with acquired immunodeficiency syndrome].

    PubMed

    Trinchieri, V; Causo, T; Fabietti, P; Bellagamba, R; Berardelli, G; Cirelli, A; Catania, S

    1992-02-01

    In this study the authors describe a non-Hodgkin's lymphoma histologically typed "large non-cleaved cell immunophenotype B cell", placed primitively into the liver. It affected a woman twenty seven years old, who contracted HIV infection due to heterosexual intercourse with at risk partner. At the time of diagnosis the woman was already considered AIDS patient on account of a previous Pneumocystis carinii pneumoniae and severe immunodeficiency (DC4 = 13 cells/mm3). The patient received cycles of chemotherapy (adriamycin 40 mg/iv, teniposide 50 mg/iv, cyclophosphamide 500 mg/iv, vincristine 2 mg/iv, bleomycin 15 mg/iv, betamethasone 4 mg/iv). At the 15th day of therapeutic cycle vincristine 2 mg/iv, bleomycin 15 mg/iv and betamethasone 4 mg/iv were given. After one cycle of therapy, hepatic echography showed signs that the lymphoma was reduced significantly. The authors stress the uncommon non-Hodgkin lymphoma localization, which is frequently underestimated in HIV-patients.

  17. Single-Center Experience of Unrelated and Haploidentical Stem Cell Transplantation with TCRαβ and CD19 Depletion in Children with Primary Immunodeficiency Syndromes.

    PubMed

    Balashov, Dmitry; Shcherbina, Anna; Maschan, Michael; Trakhtman, Pavel; Skvortsova, Yulia; Shelikhova, Larisa; Laberko, Alexandra; Livshits, Anna; Novichkova, Galina; Maschan, Alexei

    2015-11-01

    The transplantation of stem cells from a matched unrelated donor (MUD) or a haploidentical mismatched related donor (MMRD) is a widely used variant of curative treatment for patients with primary immunodeficiency (PID). Currently, different strategies are used to reduce the risk of post-transplant complications and enhance immune reconstitution. We report the preliminary results of MUD and MMRD transplantation with TCRαβ/CD19 depletion in patients with PID (trial registered at www.clinicaltrials.gov as NCT02327351). Thirty-seven PID patients (median age, 2.6 years; range, .2 to 17) were transplanted from MUDs (n = 27) or haploidentical MMRDs (n = 10) after TCRαβ(+)/CD19(+) graft depletion. The median numbers of CD34(+) and TCRαβ(+) cells in the graft were 11.7 × 10(6)/kg and 10.6 × 10(3)/kg, respectively. Acute graft-versus-host disease (GVHD) was observed in 8 patients (22%), without a statistically significant difference between MUDs and MMRDs; 7 of these patients had grade II acute GVHD and responded to first-line therapy, whereas 1 patient had grade IV acute GVHD with transformation to extensive chronic GVHD. Primary and secondary graft failure (nonengraftment or rejection) was observed in 10 patients (27%), 9 of whom were treated with 1 alkylating agent in the conditioning regimen. All these patients were successfully retransplanted with different rescue protocols. Preliminary data on immune reconstitution were very encouraging. Most patients had significant numbers of T lymphocytes detected on the first assessment (day +30) and more than 500 T cells/μL, on day +120. Based on our preliminary data, no significant difference was seen between MMRD and MUD hematopoietic stem cell transplantation (HSCT). With a median follow-up period of 15 months, the cumulative probabilities of overall patient survival and transplant-related mortality were 96.7% and 3.3%, respectively. Based on the results, the ability to control the main post

  18. The syndrome of hemophagocytic lymphohistiocytosis in primary immunodeficiencies: implications for differential diagnosis and pathogenesis

    PubMed Central

    Bode, Sebastian FN; Ammann, Sandra; Al-Herz, Waleed; Bataneant, Mihaela; Dvorak, Christopher C; Gehring, Stephan; Gennery, Andrew; Gilmour, Kimberly C; Gonzalez-Granado, Luis I; Groß-Wieltsch, Ute; Ifversen, Marianne; Lingman-Framme, Jenny; Matthes-Martin, Susanne; Mesters, Rolf; Meyts, Isabelle; van Montfrans, Joris M; Schmid, Jana Pachlopnik; Pai, Sung-Yun; Soler-Palacin, Pere; Schuermann, Uta; Schuster, Volker; Seidel, Markus G.; Speckmann, Carsten; Stepensky, Polina; Sykora, Karl-Walter; Tesi, Bianca; Vraetz, Thomas; Waruiru, Catherine; Bryceson, Yenan T.; Moshous, Despina; Lehmberg, Kai; Jordan, Michael B; Ehl, Stephan

    2015-01-01

    Hemophagocytic lymphohistiocytosis is a hyperinflammatory syndrome defined by clinical and laboratory criteria. Current criteria were created to identify patients with familial hemophagocytic lmyphohistiocytosis in immediate need of immunosuppressive therapy. However, these criteria also identify patients with infection-associated hemophagocytic inflammatory states lacking genetic defects typically predisposing to hemophagocytic lymphohistiocytosis. These patients include those with primary immunodeficiencies, in whom the pathogenesis of the inflammatory syndrome may be distinctive and aggressive immunosuppression is contraindicated. To better characterize hemophagocytic inflammation associated with immunodeficiencies, we combined an international survey with a literature search and identified 63 patients with primary immunodeficiencies other than cytotoxicity defects or X-linked lymphoproliferative disorders, presenting with conditions fulfilling current criteria for hemophagocytic lymphohistiocytosis. Twelve patients had severe combined immunodeficiency with <100/μL T cells, 18 had partial T-cell deficiencies; episodes of hemophagocytic lymphohistiocytosis were mostly associated with viral infections. Twenty-two patients had chronic granulomatous disease with hemophagocytic episodes mainly associated with bacterial infections. Compared to patients with cytotoxicity defects, patients with T-cell deficiencies had lower levels of soluble CD25 and higher ferritin concentrations. Other criteria for hemophagocytoc lymphohistiocytosis were not discriminative. Thus: (i) a hemophagocytic inflammatory syndrome fulfilling criteria for hemophagocytic lymphohistiocytosis can be the initial manifestation of primary immunodeficiencies; (ii) this syndrome can develop despite severe deficiency of T and NK cells, implying that the pathophysiology is distinct and not appropriately described as “lympho”-histiocytosis in these patients; and (iii) current criteria for

  19. The syndrome of hemophagocytic lymphohistiocytosis in primary immunodeficiencies: implications for differential diagnosis and pathogenesis.

    PubMed

    Bode, Sebastian Fn; Ammann, Sandra; Al-Herz, Waleed; Bataneant, Mihaela; Dvorak, Christopher C; Gehring, Stephan; Gennery, Andrew; Gilmour, Kimberly C; Gonzalez-Granado, Luis I; Groß-Wieltsch, Ute; Ifversen, Marianne; Lingman-Framme, Jenny; Matthes-Martin, Susanne; Mesters, Rolf; Meyts, Isabelle; van Montfrans, Joris M; Pachlopnik Schmid, Jana; Pai, Sung-Yun; Soler-Palacin, Pere; Schuermann, Uta; Schuster, Volker; Seidel, Markus G; Speckmann, Carsten; Stepensky, Polina; Sykora, Karl-Walter; Tesi, Bianca; Vraetz, Thomas; Waruiru, Catherine; Bryceson, Yenan T; Moshous, Despina; Lehmberg, Kai; Jordan, Michael B; Ehl, Stephan

    2015-07-01

    Hemophagocytic lymphohistiocytosis is a hyperinflammatory syndrome defined by clinical and laboratory criteria. Current criteria were created to identify patients with familial hemophagocytic lmyphohistiocytosis in immediate need of immunosuppressive therapy. However, these criteria also identify patients with infection-associated hemophagocytic inflammatory states lacking genetic defects typically predisposing to hemophagocytic lymphohistiocytosis. These patients include those with primary immunodeficiencies, in whom the pathogenesis of the inflammatory syndrome may be distinctive and aggressive immunosuppression is contraindicated. To better characterize hemophagocytic inflammation associated with immunodeficiencies, we combined an international survey with a literature search and identified 63 patients with primary immunodeficiencies other than cytotoxicity defects or X-linked lymphoproliferative disorders, presenting with conditions fulfilling current criteria for hemophagocytic lymphohistiocytosis. Twelve patients had severe combined immunodeficiency with <100/μL T cells, 18 had partial T-cell deficiencies; episodes of hemophagocytic lymphohistiocytosis were mostly associated with viral infections. Twenty-two patients had chronic granulomatous disease with hemophagocytic episodes mainly associated with bacterial infections. Compared to patients with cytotoxicity defects, patients with T-cell deficiencies had lower levels of soluble CD25 and higher ferritin concentrations. Other criteria for hemophagocytoc lymphohistiocytosis were not discriminative. Thus: (i) a hemophagocytic inflammatory syndrome fulfilling criteria for hemophagocytic lymphohistiocytosis can be the initial manifestation of primary immunodeficiencies; (ii) this syndrome can develop despite severe deficiency of T and NK cells, implying that the pathophysiology is distinct and not appropriately described as "lympho"-histiocytosis in these patients; and (iii) current criteria for hemophagocytoc

  20. Gene hunting in the genomic era: Approaches to diagnostic dilemmas in patients with primary immunodeficiencies

    PubMed Central

    Platt, Craig; Geha, Raif S.; Chou, Janet

    2013-01-01

    There are more than 180 different genetic causes of primary immunodeficiencies identified to date. Approaches for identifying causative mutations can be broadly classified into 3 strategies: (1) educated guesses based on known signaling pathways essential for immune cell development and function, (2) similarity of clinical phenotypes to mouse models, and (3) unbiased genetic approaches. Next-generation DNA sequencing permits efficient sequencing of whole genomes or exomes but also requires strategies for filtering vast amounts of data. Recent studies have identified ways to solve difficult cases, such as diseases with autosomal dominant inheritance, incomplete penetrance, or mutations in noncoding regions. This review focuses on recently identified primary immunodeficiencies to illustrate the strategies, technologies, and potential pitfalls in finding novel causes of these diseases. PMID:24100122

  1. [Phenotypic diagnosis of primary immunodeficiencies in Antioquia, Colombia, 1994-2002].

    PubMed

    Montoya, Carlos Julio; Henao, Julieta; Salgado, Helí; Olivares, María M; López, Juan A; Rugeles, Claudia; Franco, José Luis; Orrego, Julio; García, Diana M; Patiño, Pablo J

    2002-12-01

    Recurrent infections are a frequent cause of medical visits. They can be due to a heterogeneous group of dysfunctions that increase the susceptibility to pathogenic and opportunistic microorganisms, such as immunological deficiencies. To define an opportune rational treatment and to guide the molecular diagnosis of primary immunodeficiency diseases, we establish a program for the phenotypic diagnosis of these illnesses in Antioquia, Colombia, including clinical and laboratory evaluations of patients who present recurrent infections with abnormal evolution. Between August 1, 1994 and July 31, 2002, phenotypic diagnosis of primary immunodeficiency was made in 98 patients. Similar to data reported in the literature, antibody deficiencies were the most frequent (40.8%), followed by combined deficiencies (21.4%). This phenotypic characterization has allowed for appropriate treatments for each patient and, in some cases, functional and molecular studies that can lead to a definite molecular diagnosis.

  2. Severe Thrombocytopenia and Acute Cytomegalovirus Colitis during Primary Human Immunodeficiency Virus Infection

    PubMed Central

    Furuhata, Masanori; Yanagisawa, Naoki; Nishiki, Shingo; Sasaki, Shugo; Suganuma, Akihiko; Imamura, Akifumi; Ajisawa, Atsushi

    2016-01-01

    We herein report the case of a 25-year-old man who was referred to our hospital due to acute cytomegalovirus (CMV) colitis. The initial blood tests showed that the patient had concurrent primary human immunodeficiency virus (HIV) infection and severe thrombocytopenia. Raltegravir-based antiretroviral therapy (ART) was initiated without the use of ganciclovir or corticosteroids and resulted in a rapid clinical improvement. Platelet transfusions were only necessary for a short period, and subsequent colonoscopy revealed a completely healed ulcer. This case implies that ART alone could be effective for treating severe thrombocytopenia during primary HIV and CMV coinfection. PMID:27980271

  3. Gene transfer into hematopoietic stem cells as treatment for primary immunodeficiency diseases.

    PubMed

    Candotti, Fabio

    2014-04-01

    Gene transfer into the hematopoietic stem cell has shown curative potential for a variety of hematological disorders. Primary immunodeficiency diseases have led to the way in this field of gene therapy as an example and a model. Clinical results from the past 15 years have shown that significant improvement and even cure can be achieved for diseases such as X-linked severe combined immunodeficiency, adenosine deaminase deficiency, chronic granulomatous disease and Wiskott-Aldrich syndrome. Unfortunately, with the initial clear clinical benefits, the first serious complications of gene therapy have also occurred. In a significant number of patients treated using vectors based on murine gamma-retroviruses and carrying powerful viral enhancer elements, insertional oncogenesis events have resulted in acute leukemias that, in some cases, have had fatal outcomes. These serious adverse events have sparked a revision of the assessment of risks and benefits of integrating gene transfer for hematological diseases and prompted the development and application of new generations of viral vectors with recognized superior safety characteristics. This review summarizes the clinical experience of gene therapy for primary immunodeficiencies and discusses the likely avenues of progress in the future development of this expanding field of clinical investigations.

  4. Inflammatory Duodenal Polyposis Associated with Primary Immunodeficiency Disease: A Novel Case Report

    PubMed Central

    Shera, Irfan Ali; Khurshid, Sheikh Mudassir

    2017-01-01

    Agammaglobulinemia is a rare form of B-cell primary immunodeficiency disease characterized by reduced levels of IgG, IgA, or IgM and recurrent bacterial infections. Agammaglobulinemia is most commonly associated with diffuse nodular lymphoid hyperplasia. Duodenal polyps are a rare entity; however, due to wide use of esophagogastroduodenoscopy, incidental diagnosis of duodenal polyps appears to be increasing. Although inflammatory duodenal polyposis has been reported in the literature, its association with common variable immunodeficiency has not been reported till date to the best of our knowledge. We report a case of a 59-year-old male with chronic symptoms of agammaglobulinemia associated with inflammatory duodenal polyposis. PMID:28163721

  5. Formalin-treated bacteria as selective B cell mitogens: results in primary and acquired immunodeficiencies.

    PubMed Central

    Sirianni, M C; Pucillo, L P; Fiorilli, M; Aiuti, F; Banck, G; Forsgren, A

    1981-01-01

    The mitogenic activity of the formalin-treated bacterial strains Branhamella catarrhalis, Haemophilus influenzae and the Cowan I strain of Staphylococcus aureus was assessed in peripheral blood lymphocytes (PBL) from patients with primary immunodeficiencies, acute lymphocytic leukaemia (ALL), chronic lymphocytic leukemia (CLL) and in umbilical cord blood lymphocytes. The bacteria selectively stimulated B cells, as demonstrated by the finding of a normal de novo DNA synthesis in children with a T cell defect and of an absent response in X-linked agammaglobulinaemia and severe combined immunodeficiency. A decreased mitogenic activity was exerted on PBL from four out of seven adults with common variable hypogammaglobulinemia (CVH). In B-CLL the mitogenic activity was normal while in T-ALL it was decreased. Umbilical cord blood lymphocytes responded better than PBL from adults. The selective stimulative ability of the bacteria for B lymphocytes is expressed when PBL are cultured together with the formalin-treated bacteria for 48 to 72 hr. PMID:6976247

  6. Improving cellular therapy for primary immune deficiency diseases: Recognition, diagnosis, and management

    PubMed Central

    Griffith, Linda M.; Cowan, Morton J.; Notarangelo, Luigi D.; Puck, Jennifer M.; Buckley, Rebecca H.; Candotti, Fabio; Conley, Mary Ellen; Fleisher, Thomas A.; Gaspar, H. Bobby; Kohn, Donald B.; Ochs, Hans D.; O'Reilly, Richard J.; Rizzo, J. Douglas; Roifman, Chaim M.; Small, Trudy N.; Shearer, William T.

    2010-01-01

    More than 20 North American academic centers account for the majority of hematopoietic stem cell transplantation (HCT) procedures for primary immunodeficiency diseases (PIDs), with smaller numbers performed at additional sites. Given the importance of a timely diagnosis of these rare diseases and the diversity of practice sites, there is a need for guidance as to best practices in management of patients with PIDs before, during, and in follow-up for definitive treatment. In this conference report of immune deficiency experts and HCT physicians who care for patients with PIDs, we present expert guidance for (1) PID diagnoses that are indications for HCT, including severe combined immunodeficiency disease (SCID), combined immunodeficiency disease, and other non-SCID diseases; (2) the critical importance of a high degree of suspicion of the primary care physician and timeliness of diagnosis for PIDs; (3) the need for rapid referral to an immune deficiency expert, center with experience in HCT, or both for patients with PIDs; (4) medical management of a child with suspicion of SCID/combined immunodeficiency disease while confirming the diagnosis, including infectious disease management and workup; (5) the posttransplantation follow-up visit schedule; (6) antimicrobial prophylaxis after transplantation, including gamma globulin administration; and (7) important indications for return to the transplantation center after discharge. Finally, we discuss the role of high-quality databases in treatment of PIDs and HCTas an element of the infrastructure that will be needed for productive multicenter clinical trials in these rare diseases. PMID:20004776

  7. Improving cellular therapy for primary immune deficiency diseases: recognition, diagnosis, and management.

    PubMed

    Griffith, Linda M; Cowan, Morton J; Notarangelo, Luigi D; Puck, Jennifer M; Buckley, Rebecca H; Candotti, Fabio; Conley, Mary Ellen; Fleisher, Thomas A; Gaspar, H Bobby; Kohn, Donald B; Ochs, Hans D; O'Reilly, Richard J; Rizzo, J Douglas; Roifman, Chaim M; Small, Trudy N; Shearer, William T

    2009-12-01

    More than 20 North American academic centers account for the majority of hematopoietic stem cell transplantation (HCT) procedures for primary immunodeficiency diseases (PIDs), with smaller numbers performed at additional sites. Given the importance of a timely diagnosis of these rare diseases and the diversity of practice sites, there is a need for guidance as to best practices in management of patients with PIDs before, during, and in follow-up for definitive treatment. In this conference report of immune deficiency experts and HCT physicians who care for patients with PIDs, we present expert guidance for (1) PID diagnoses that are indications for HCT, including severe combined immunodeficiency disease (SCID), combined immunodeficiency disease, and other non-SCID diseases; (2) the critical importance of a high degree of suspicion of the primary care physician and timeliness of diagnosis for PIDs; (3) the need for rapid referral to an immune deficiency expert, center with experience in HCT, or both for patients with PIDs; (4) medical management of a child with suspicion of SCID/combined immunodeficiency disease while confirming the diagnosis, including infectious disease management and workup; (5) the posttransplantation follow-up visit schedule; (6) antimicrobial prophylaxis after transplantation, including gamma globulin administration; and (7) important indications for return to the transplantation center after discharge. Finally, we discuss the role of high-quality databases in treatment of PIDs and HCT as an element of the infrastructure that will be needed for productive multicenter clinical trials in these rare diseases.

  8. Does the proper intravenous immunoglobulin substitution in primary immunodeficiency protect against HBV infections?: a description of a case series.

    PubMed

    Joanna, Glück; Slawomir, Zeglen; Barbara, Rymarczyk; Barbara, Rogala

    2008-09-01

    There are no recommendations concerning preoperative management of primary immunodeficiency patients in cases of emergency or planned surgery in relation to risk of hepatitis type B virus infection. To assess if immunodeficient patients regularly supplemented with immunoglobulins are protected against hepatitis B. IgG, IgM and IgA total levels and anti-HBs level were estimated in adult patients with primary humoral immunodeficiency before and after immunoglobulins supplementation according to a standardized schedule. Serum IgG and anti-HBs level significantly increased after immunoglobulin supplementation. Anti-HBs titer increased in all cases over 100 IU/L regardless of initial total IgG serum value, reaching a highly protective level. There was no correlation between increase in concentration of IgG (DeltaIgG) versus Deltaanti-HBs in the studied patients. Patients with primary hypogammaglobulinemia supplemented with immunoglobulin are protected against hepatitis type B.

  9. [Sepsis due to Pseudomona as a debut of a primary immunodeficiency in a child].

    PubMed

    Vera Sáez-Benito, M Cristina; López Úbeda, Marta; Madurga Revilla, Paula; de Arriba Muñoz, Antonio; Bustillo Alonso, Matilde; Rodríguez-Vigil Iturrate, Carmen

    2016-12-01

    X-linked agammaglobulinemia is a primary humoral immunodeficiency. It is a recessive X-linked disorder characterized by low or absent circulating mature B cells, hypo/agammaglobulinemia and no humoral response to immunizations due to mutations along chromosome X. It is characterized by severe, recurrent and difficult treatment infections. It is diagnosed in the first 6 months of life in children; the only sign of alarm is the absent or decreased size of tonsils and lymph nodes, but it is not always present. The main cornerstones of treatment are immunoglobulin replacement therapy to maintain serum levels above 500-700 mg/dl and infection control; this allows these patients to do their day-to-day activities. We report a 2 year old boy with X-linked agammaglobulinemia, with no history of interest, who presented with P. aeruginosa sepsis. He had an excellent clinical improvement without further important infections after intravenous immunoglobulin replacement therapy.

  10. Immune globulin (human) 10 % liquid: a review of its use in primary immunodeficiency disorders.

    PubMed

    McCormack, Paul L

    2013-08-01

    Human immune globulin (IG) 10 % liquid (Gammagard Liquid®) is a ready-to-use, highly purified, and concentrated immunoglobulin (Ig)G solution approved in the US for both intravenous and subcutaneous antibody replacement therapy in patients aged ≥ 2 years with primary humoral immunodeficiency. Intravenous IG 10 % liquid every 3-4 weeks for ≥ 12 months, at median serum IgG trough levels of 9.6-11.2 g/L, completely prevented acute serious bacterial infections (SBIs) in a phase III clinical trial. Weekly subcutaneous IG 10 % liquid at a dose equal to 137 % of the equivalent weekly intravenous dose, which was earlier determined to produce the same IgG exposure, produced higher serum trough IgG levels and lower peak IgG levels than intravenous administration, and also effectively reduced SBIs; the infection rate was 0.067 SBIs/subject/year, which met the US FDA efficacy criterion of < 1 SBI/subject/year. The rates for non-serious infections of any kind were low for both intravenous and subcutaneous therapy. Both intravenous and subcutaneous IG 10 % liquid were safe and generally well tolerated. Systemic adverse reactions were more frequent with intravenous therapy and local infusion-site reactions were more frequent with subcutaneous therapy, but the latter reduced over time. Most adverse reactions were of mild or moderate intensity. Thus, IG 10 % liquid is an effective and generally well-tolerated preparation for both intravenous and subcutaneous IgG replacement therapy in patients with primary immunodeficiency disorders involving antibody deficiency. It offers the benefits of a ready-to-use, liquid preparation and the convenience of home-based therapy in appropriate patients.

  11. Immunodeficiency disorders in horses.

    PubMed

    Crisman, Mark V; Scarratt, W Kent

    2008-08-01

    Immunodeficiencies are characterized as primary (genetic) or secondary (acquired). Primary immunodeficiencies are relatively uncommon; however, clinically, they present a significant challenge to the practitioner, especially if the underlying disorder goes unrecognized. Secondary immunodeficiencies may present at any age, but failure of passive transfer in neonatal foals is most commonly encountered. This article provides a general overview of clinical signs and diagnosis of primary and secondary immunodeficiencies currently recognized in horses.

  12. Replication of human immunodeficiency virus type 1 in primary dendritic cell cultures.

    PubMed Central

    Langhoff, E; Terwilliger, E F; Bos, H J; Kalland, K H; Poznansky, M C; Bacon, O M; Haseltine, W A

    1991-01-01

    The ability of the human immunodeficiency virus type 1 (HIV-1) to replicate in primary blood dendritic cells was investigated. Dendritic cells compose less than 1% of the circulating leukocytes and are nondividing cells. Highly purified preparations of dendritic cells were obtained using recent advances in cell fractionation. The results of these experiments show that dendritic cells, in contrast to monocytes and T cells, support the active replication of all strains of HIV-1 tested, including T-cell tropic and monocyte/macrophage tropic isolates. The dendritic cell cultures supported much more virus production than did cultures of primary unseparated T cells, CD4+ T cells, and adherent as well as nonadherent monocytes. Replication of HIV-1 in dendritic cells produces no noticeable cytopathic effect nor does it decrease total cell number. The ability of the nonreplicating dendritic cells to support high levels of replication of HIV-1 suggests that this antigen-presenting cell population, which is also capable of supporting clonal T-cell growth, may play a central role in HIV pathogenesis, serving as a source of continued infection of CD4+ T cells and as a reservoir of virus infection. Images PMID:1910172

  13. Efficacy, safety and pharmacokinetics of a novel subcutaneous immunoglobulin, Evogam®, in primary immunodeficiency.

    PubMed

    Empson, Marianne B; Tang, Mimi L K; Pearce, Lisa K C; Rozen, Leon; Gold, Michael S; Katelaris, Constance H; Langton, David; Smart, Joanne; Smith, William B; Steele, Richard H; Ziegler, John B; Maher, Darryl

    2012-10-01

    This phase III, open-label, multi-centre study investigated the efficacy, safety, pharmacokinetics and quality of life impact of Evogam(®), a new chromatographically fractionated 16% subcutaneous immunoglobulin, utilising a 1:1 dose transition ratio from previous immunoglobulin therapy. Thirty-five previously treated patients with primary immunodeficiency received weekly Evogam over 36 weeks. Primary endpoints were rate of serious bacterial infections (SBIs) and steady-state serum immunoglobulin G (IgG) trough concentrations. No SBIs were reported during the study. Evogam produced significantly higher mean trough IgG concentrations with 1:1 dose conversion compared to previous immunoglobulin treatment (8.94 versus 8.27 g/L, p = 0.0063). Evogam was efficacious in the prevention of infections and maintenance of trough levels using a 1:1 dose conversion. It was well tolerated with no withdrawals due to adverse events and was preferred to IVIg by the majority of patients.

  14. Disseminated bronchiectasis in an adult with common variable immunodeficiency

    PubMed Central

    Agudelo-Rojas, Olga Lucia

    2015-01-01

    Primary immunodeficiencies (PID) are traditionally considered childhood diseases; however, adults account for 35% of all patients with PID. Antibody deficiencies, especially Common Variable Immunodeficiency (CVID), which have their peak incidence in adulthood, require a high suspicion index. Even though the estimated frequency of CVID is not high (1:25,000), high rates of under diagnosis and under reporting are very likely. The delay in diagnosis increases the morbidity and mortality; therefore, adult physicians should be able to suspect, identify and initiate management of individuals with PID. Here we report the case of a 37 year-old man presenting to the emergency room with dyspnea, fever and cough; he developed respiratory failure requiring mechanical ventilation. He complained of recurring pneumonia associated with widespread bronchiectasis since he was 18 years old. Serum immunoglobulins quantification showed severe hypogammaglobulinemia (total IgG <140 mg/dL; total IgA, 2.9 mg/dL; and total IgM <5 mg/dL). Treatment with Human Intravenous Immunoglobulin (IVIG) 10% was started, and with antibiotic treatment for severe pneumonia (during 14 days) was also prescribed. His clinical evolution has been favorable after one year follow-up. Common Variable Immunodeficiency (CVID) diagnosis was made. PMID:26019385

  15. Disseminated bronchiectasis in an adult with common variable immunodeficiency.

    PubMed

    Zea-Vera, Andrés Felipe; Agudelo-Rojas, Olga Lucia

    2015-01-01

    Primary immunodeficiencies (PID) are traditionally considered childhood diseases; however, adults account for 35% of all patients with PID. Antibody deficiencies, especially Common Variable Immunodeficiency (CVID), which have their peak incidence in adulthood, require a high suspicion index. Even though the estimated frequency of CVID is not high (1:25,000), high rates of under diagnosis and under reporting are very likely. The delay in diagnosis increases the morbidity and mortality; therefore, adult physicians should be able to suspect, identify and initiate management of individuals with PID. Here we report the case of a 37 year-old man presenting to the emergency room with dyspnea, fever and cough; he developed respiratory failure requiring mechanical ventilation. He complained of recurring pneumonia associated with widespread bronchiectasis since he was 18 years old. Serum immunoglobulins quantification showed severe hypogammaglobulinemia (total IgG <140 mg/dL; total IgA, 2.9 mg/dL; and total IgM <5 mg/dL). Treatment with Human Intravenous Immunoglobulin (IVIG) 10% was started, and with antibiotic treatment for severe pneumonia (during 14 days) was also prescribed. His clinical evolution has been favorable after one year follow-up. Common Variable Immunodeficiency (CVID) diagnosis was made.

  16. Efficacy of subcutaneous immunoglobulins in primary immunodeficiency with Crohn's-like phenotype: report of a case.

    PubMed

    Sanges, M; Spadaro, G; Miniero, M; Mattera, D; Sollazzo, R; D'Armiento, F P; De Palma, G D; Pecoraro, A; Borrelli, F; Genovese, A; D'Arienzo, A

    2015-01-01

    Common variable immune deficiency (CVID) is the most frequent primary immunodeficiency in adults. In CVID, the prevalence of gastrointestinal manifestations ranges between 2 and 50% with a complication-related morbidity second only to that of the respiratory tract. In some cases, clinical and endoscopic features are undistinguishable from those of inflammatory bowel disease (IBD). We describe the case of a 28-year-old man in which a diagnosis of Crohn's disease was firstly suspected. Subsequently, a diagnosis of Crohn's-like disease in a patient with CVID was made and a replacement therapy with human normal immunoglobulin intravenously was started. Unfortunately, serum IgG levels remained below 2.0 g/l in pre-infusional controls with persistence of gastrointestinal symptoms and malnutrition despite anti-inflammatory therapy (mesalazine, corticosteroids). Then, the patient began treatment with human normal immunoglobulins administered subcutaneously. The follow-up visits showed a progressive increase in serum IgG. Moreover, the patient reported improvement of gastrointestinal symptoms with reduction of diarrhoea, and laboratory tests showed a progressive and significant improvement. We confirm that therapy with subcutaneously administered immunoglobulins is safe and effective. In addition, our observations indicate that, for patients with CVID and enteropathic complications, replacement therapy with subcutaneous IgG may be the treatment of choice.

  17. Subcutaneous immunoglobulins: product characteristics and their role in primary immunodeficiency disease.

    PubMed

    Melamed, Isaac; Testori, Alessandro; Spirer, Zvi

    2012-12-01

    Research on the role of subcutaneous immunoglobulin in primary immunodeficiency disease (PIDD) is ongoing. We analyzed pivotal studies for four subcutaneous immunoglobulin products: IGSC 10% (Gammagard(®) Liquid), IGIV-C 10% (Gamunex(®)-C), IGSC 16% (Vivaglobin(®)) and IGSC 20% (Hizentra(®)). To identify similarities and differences between products, we examined infusion parameters, adverse event profiles and improvements in tolerability over time. Maximum volume infused was 30 mL/site for IGSC 10%, 34 mL/site for IGIV-C 10%, 15 mL/site for IGSC 16% and 25 mL/site for IGSC 20%. Maximum number of simultaneous infusion sites was 10 for IGSC 10%, 8 for IGIV-C 10%, 6 for IGSC 16% and 4 for IGSC 20%. Local adverse reaction rate per infusion was 0.02 for IGSC 10%, 0.59 for IGIV-C, 0.49 for IGSC 16% and 0.58 for IGSC 20%. IGSC products have similar efficacy profiles; however, their tolerability profiles vary. Reasons for these differences are unknown and warrant further research.

  18. Critical issues and needs in management of primary immunodeficiency diseases in Latin America.

    PubMed

    Condino-Neto, A; Franco, J L; Trujillo-Vargas, C; Espinosa-Rosales, F J; Leiva, L E; Rodriguez-Quiroz, F; King, A; Lagos, M; Oleastro, M; Bezrodnik, L; Grumach, A S; Costa-Carvalho, B T; Sorensen, R U

    2011-01-01

    Experts from six Latin American countries met to discuss critical issues and needs in the diagnosis and management of primary immunodeficiency diseases (PIDD). The diagnosis of PIDD is generally made following referral to an immunology centre located in a major city, but many paediatricians and general practitioners are not sufficiently trained to suspect PIDD in the first place. Access to laboratory testing is generally limited, and only some screening tests are typically covered by government health programmes. Specialised diagnostic tests are generally not reimbursed. Access to treatment varies by country reflecting differences in healthcare systems and reimbursement policies. An online PIDD Registry Programme for Latin America has been available since 2009, which will provide information about PIDD epidemiology in the region. Additional collaboration across countries appears feasible in at least two areas: a laboratory network to facilitate the diagnosis of PIDD, and educational programmes to improve PIDD awareness. In total, these collaborations should make it possible to advance the diagnosis and management of PIDD in Latin America.

  19. Imbalances of T cell subpopulations in primary immunodeficiencies and systemic lupus erythematosus.

    PubMed

    Pandolfi, F; Quinti, I; Sirianni, M C; Fiorilli, M; Zolla, S; Aiuti, F

    1981-01-01

    In the present report we describe a recently proposed technique for the enumeration of T lymphocyte subpopulations. The study was performed on peripheral blood lymphocytes (PBL) of 21 patients with primary immunodeficiencies and 10 with systemic lupus erythematosus (SLE). With this methodology, sheep rosettes are evaluated before and after preincubation with theophylline. Previous reports have shown that cells rosetting after the preincubation (T-res) contain most of the percentages of the helper activity, whereas sensitive cells (T-sens) exert suppression. T-res and T-sens cells were compared to several clinical and immunological parameters, including the detection of lymphocytes with Fc IgM and IgG receptors. We demonstrated a significant positive correlation between T-res and and EAox IgM cells and between T-sens and EAox IgG cells. In addition, patients with Ig defects demonstrated heterogeneity regarding alterations in the proportions of T-res and T-sens cells. On the contrary, in 8 patients with SLE, there was a markedly reduced proportion of T-sens cells. Variations in the balance of subpopulations were observed after treatment with thymic hormones and levamisole. We may conclude that theophylline rosettes represent an easy technique that can be profitably used in the evaluation of T cell subpopulations in immunological diseases.

  20. Hematopoietic stem cell transplantation for pediatric patients with primary immunodeficiency diseases at All Children's Hospital/University of South Florida.

    PubMed

    Petrovic, A; Dorsey, M; Miotke, J; Shepherd, C; Day, N

    2009-01-01

    We retrospectively analyzed the transplantation outcomes of 31 patients with primary immunodeficiency diseases treated at our center (All Children's Hospital, University of South Florida) since its inception in 1986. The primary immune diseases included severe combined immunodeficiency, Wiscott-Aldrich syndrome, X-linked hyper-IgM syndrome, and chronic granulomatous disease. The age of the patient's at the time of transplant ranged from 1 month to 19 years, and conditioning regimens varied based on the patients underlying disease. In 23 patients, the graft source was bone marrow, 4 patients received umbilical cord blood grafts and 4 patients received peripheral blood stem cell grafts. Better survival rates were observed in those patients transplanted at a younger age and free of infections, demonstrating that transplantation at an early age before significant infections, autoimmune manifestation and malignant transformation have occurred is beneficial.

  1. Serotyping of primary human immunodeficiency virus type 1 isolates from diverse geographic locations by flow cytometry.

    PubMed Central

    Zolla-Pazner, S; O'Leary, J; Burda, S; Gorny, M K; Kim, M; Mascola, J; McCutchan, F

    1995-01-01

    The immunologic relatedness of the various human immunodeficiency virus type 1 (HIV-1) clades was determined with 13 human anti-HIV-1 monoclonal antibodies (MAbs) to six immunogenic regions of the HIV-1 structural proteins. The immunoreactivity of the native, oligomeric viral envelope glycoproteins expressed on the surfaces of human peripheral blood mononuclear cells infected in vitro with primary isolates from clades A through E was determined by flow cytometry. Some epitopes in the immunodominant region of gp41 and the C terminus of gp120 appear to be HIV-1 group specific in that they are expressed on the surfaces of cells in cultures infected with the majority of viruses tested from clades A to E. Epitopes within the V3 region appear to be clade restricted. Surprisingly, one MAb to an epitope in the C terminus of gp120 was entirely clade B specific. Staining with anti-V2 and anti-CD4 binding domain (CD4bd) reagents was infrequently detected. Anti-CD4bd MAbs stained only CD4-negative T cells because the CD4bd of gp120 appeared to be complexed with membrane CD4. When present, the epitopes of V2 and the CD4bd appeared to be expressed on cells infected with various clades. Thus, the results suggest that MAbs to gp41, the C terminus, and the V3 loop of gp120 are most useful in serotyping primary isolates of HIV-1, providing group-specific, clade-restricted, and clade-specific reagents. The use of the immunofluorescent method with the reagents described herein distinguishes infection with clade B from that with all other HIV-1 clades. With additional MAbs, this technique will allow a broadly applicable, reproducible, and practical method for serotyping HIV-1. PMID:7745728

  2. Indications to Epigenetic Dysfunction in the Pathogenesis of Common Variable Immunodeficiency.

    PubMed

    Rae, William

    2017-04-01

    Primary immunodeficiencies (PIDs) are a group of rare genetic diseases resulting in the impairment of one or more functions of the human immune system. Common variable immunodeficiency (CVID) is one of the most prevalent PIDs, yet despite extensive genetic analysis, most patients do not have a monogenetic diagnosis. This has led to the theory that CVID must be a polygenetic condition. An alternative theory to a monogenetic or polygenetic underlying cause of CVID is that it is epigenetic phenomena that are causal in the majority of CVID patients. I will briefly discuss epigenetic regulation in B-cell biology and development, current examples of epigenetic diseases causing CVID-like primary antibody deficiencies, and how these observations may guide future investigation into the role of epigenetics in CVID.

  3. B-cell Lymphoproliferative Disorders Associated with Primary and Acquired Immunodeficiency.

    PubMed

    Low, Lawrence K; Song, Joo Y

    2016-03-01

    The diagnosis of lymphoproliferative disorders associated with immunodeficiency can be challenging because many of these conditions have overlapping clinical and pathologic features and share similarities with their counterparts in the immunocompetent setting. There are subtle but important differences between these conditions that are important to recognize for prognostic and therapeutic purposes. This article provides a clinicopathologic update on how understanding of these B-cell lymphoproliferations in immunodeficiency has evolved over the past decade.

  4. 'Pseudolymphoma'. A case associated with primary immunodeficiency disease and polyglandular failure syndrome.

    PubMed

    Snover, D C; Filipovich, A H; Dehner, L P; Krivit, W

    1981-01-01

    An atypical lymphoproliferative process occurred in the liver and spleen of a child with combined immunodeficiency disease and polyglandular failure syndrome. The initial pathologic interpretation was that of malignant lymphoma, although the child's subsequent clinical course was complicated by rheumatoid arthritis, thyroiditis, and chronic active hepatitis, with no clear evidence of lymphoid neoplasia. This case illustrates that unusual lymphoid proliferations in patients with immunodeficiencies may simulate malignant lymphoma.

  5. Immunodeficiency disorders.

    PubMed

    Cooper, Max D; Lanier, Lewis L; Conley, Mary Ellen; Puck, Jennifer M

    2003-01-01

    Hematological complications occur frequently in patients with both primary and secondary immunodeficiency disorders. Anemia, thrombocytopenia or leukopenias may bring these individuals to the attention of hematologists. Conversely, evidence suggesting a lymphoproliferative disorder may be the cause for referral. This session will provide an update on the diagnosis and treatment of immunodeficiency diseases ranging from isolated defects in antibody production to the severe combined immunodeficiencies (SCID). Immunodeficiency diseases have traditionally been defined as defects in the development and function of T and B cells, the primary effector cells of specific cellular and humoral immunity. However, it has become increasingly evident that innate immune mechanisms contribute greatly to host defense, either through acting alone or by enhancing specific T and B cell responses. In Section I, Dr. Lewis Lanier reviews the burgeoning information on the extensive families of activating and inhibitory immunoreceptors that are expressed on NK cells, dendritic cells, T and B cells, and phagocytic cells. He provides an overview on the biological functions of these receptors in host defense. In Section II, Dr. Mary Ellen Conley defines the spectrum of antibody deficiency disorders, the most frequently occurring types of primary immunodeficiencies. She covers the different defects in B-cell development and function that lead to antibody deficiencies, and includes diagnosis and therapy of these disorders. In Section III, Dr. Jennifer Puck discusses the diagnosis and treatment of the different types of SCID. She describes the genetic basis for SCID, and the benefits, pitfalls, and complications of gene therapy and bone marrow transplantation in SCID patients.

  6. Treatment of Pediatric Acute Graft-versus-Host Disease—Lessons from Primary Immunodeficiency?

    PubMed Central

    Flinn, Aisling M.; Gennery, Andrew R.

    2017-01-01

    Allogeneic hematopoietic stem cell transplant (HSCT) is used to treat increasing numbers of malignant and non-malignant disorders. Despite significant advances in improved human leukocyte antigens-typing techniques, less toxic conditioning regimens and better supportive care, resulting in improved clinical outcomes, acute graft-versus-host disease (aGvHD) continues to be a major obstacle and, although it principally involves the skin, gastrointestinal tract, and liver, the thymus is also a primary target. An important aim following HSCT is to achieve complete and durable immunoreconstitution with a diverse T-cell receptor (TCR) repertoire to recognize a broad range of pathogens providing adequate long-term adaptive T-lymphocyte immunity, essential to reduce the risk of infection, disease relapse, and secondary malignancies. Reconstitution of adaptive T-lymphocyte immunity is a lengthy and complex process which requires a functioning and structurally intact thymus responsible for the production of new naïve T-lymphocytes with a broad TCR repertoire. Damage to the thymic microenvironment, secondary to aGvHD and the effect of corticosteroid treatment, disturbs normal signaling required for thymocyte development, resulting in impaired T-lymphopoiesis and reduced thymic export. Primary immunodeficiencies, in which failure of central or peripheral tolerance is a major feature, because of intrinsic defects in hematopoietic stem cells leading to abnormal T-lymphocyte development, or defects in thymic stroma, can give insights into critical processes important for recovery from aGvHD. Extracorporeal photopheresis is a potential alternative therapy for aGvHD, which acts in an immunomodulatory fashion, through the generation of regulatory T-lymphocytes (Tregs), alteration of cytokine patterns and modulation of dendritic cells. Promoting normal central and peripheral immune tolerance, with selective downregulation of immune stimulation, could reduce aGvHD, and enable a

  7. Gene therapy for PIDs: progress, pitfalls and prospects.

    PubMed

    Mukherjee, Sayandip; Thrasher, Adrian J

    2013-08-10

    Substantial progress has been made in the past decade in treating several primary immunodeficiency disorders (PIDs) with gene therapy. Current approaches are based on ex-vivo transfer of therapeutic transgene via viral vectors to patient-derived autologous hematopoietic stem cells (HSCs) followed by transplantation back to the patient with or without conditioning. The overall outcome from all the clinical trials targeting different PIDs has been extremely encouraging but not without caveats. Malignant outcomes from insertional mutagenesis have featured prominently in the adverse events associated with these trials and have warranted intense pre-clinical investigation into defining the tendencies of different viral vectors for genomic integration. Coupled with issues pertaining to transgene expression, the therapeutic landscape has undergone a paradigm shift in determining safety, stability and efficacy of gene therapy approaches. In this review, we aim to summarize the progress made in the gene therapy trials targeting ADA-SCID, SCID-X1, CGD and WAS, review the pitfalls, and outline the recent advancements which are expected to further enhance favourable risk benefit ratios for gene therapeutic approaches in the future.

  8. Efficacy and safety of home-based subcutaneous immunoglobulin replacement therapy in paediatric patients with primary immunodeficiencies.

    PubMed

    Borte, M; Bernatowska, E; Ochs, H D; Roifman, C M

    2011-06-01

    Subcutaneous immunoglobulin infusions are effective, safe and well tolerated in the treatment of primary immunodeficiencies, but only limited data on the treatment of children are available. We investigated the efficacy, safety and pharmacokinetics of home therapy with a 16% liquid human immunoglobulin G preparation (Vivaglobin®) when administered subcutaneously in children with primary immunodeficiencies. Data were analysed from 22 children (2-<12 years) who participated in two prospective, open-label studies (one in Europe/Brazil, one in North America). All children had previously received intravenous immunoglobulins. They started weekly subcutaneous immunoglobulin infusions with an approximately 3-month wash-in/wash-out period, followed by a 6-month (Europe/Brazil) or 12-month (North America) efficacy evaluation period. In Europe/Brazil, subcutaneous doses generally equalled the previous weekly equivalent intravenous doses. In North America, subcutaneous doses during the efficacy evaluation period were 126% (median) of the previous weekly equivalent intravenous doses. Efficacy end-points in both studies included the occurrence of serious bacterial infections and any infections, and serum immunoglobulin G trough levels. Median serum immunoglobulin G trough levels exceeded those during previous intravenous therapy by 13% (North America) and 16% (Europe/Brazil). During the efficacy evaluation period of both studies, none of the children had a serious bacterial infection; the mean overall infection rate/patient year was 4·7 in Europe/Brazil and 5·6 in North America, concurring with previous reports in adults. The adverse event profile was comparable to previous reports in adults. Both studies confirmed the efficacy and safety of subcutaneous immunoglobulin therapy with Vivaglobin in children with primary immunodeficiencies.

  9. Late-Onset Combined Immunodeficiency with a Novel IL2RG Mutation and Probable Revertant Somatic Mosaicism.

    PubMed

    Okuno, Yusuke; Hoshino, Akihiro; Muramatsu, Hideki; Kawashima, Nozomu; Wang, Xinan; Yoshida, Kenichi; Wada, Taizo; Gunji, Masaharu; Toma, Tomoko; Kato, Tamaki; Shiraishi, Yuichi; Iwata, Atsuko; Hori, Toshinori; Kitoh, Toshiyuki; Chiba, Kenichi; Tanaka, Hiroko; Sanada, Masashi; Takahashi, Yoshiyuki; Nonoyama, Shigeaki; Ito, Masafumi; Miyano, Satoru; Ogawa, Seishi; Kojima, Seiji; Kanegane, Hirokazu

    2015-10-01

    Primary immunodeficiency disease (PID) is caused by mutations of more than two hundred immunity-related genes. In addition to the heterogeneity of the diseases, the atypical presentation of each disease caused by hypomorphic mutations or somatic mosaicism makes genetic diagnosis challenging. Next-generation sequencing tests all genes simultaneously and has proven its innovative efficacy in genomics. We describe a male PID patient without any family history of immunodeficiency. This patient suffered from recurrent infections from 1 year of age. Laboratory analysis showed hypogammaglobulinemia. T, B, and NK cells were present, but the T cell proliferative response decreased. Whole-exome sequencing analysis identified an IL2RG p.P58T missense mutation. CD8(+) and CD56(+) cells showed revertant somatic mosaicism to the wild-type allele. A late-onset and atypical presentation of the X-linked severe combined immunodeficiency (X-SCID) phenotype might be associated with revertant somatic mosaicism in T and NK cells. This patient is the seventh reported case of X-SCID with revertant somatic mosaicism. His classical clinical management did not result in a molecular diagnosis because of the atypical presentation. The coverage that is provided by whole-exome sequencing of most PID genes effectively excluded differential diagnoses other than X-SCID. As next-generation sequencing becomes available in clinical practice, it will enhance our knowledge of PID and rescue currently undiagnosed patients.

  10. PID controllers' fragility.

    PubMed

    Alfaro, Víctor M

    2007-10-01

    In this paper, an index for measuring fragility of proportional integral derivative (PID) controllers is proposed. This index relates the losses of robustness of the control loop when controller parameters change, to the nominal robustness of the control loop. Furthermore, it defines when a PID controller is fragile, nonfragile or resilient.

  11. Pelvic Inflammatory Disease (PID)

    MedlinePlus

    Pelvic Inflammatory Disease (PID) - CDC Fact Sheet Untreated sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a ... tubal blockage; •• Ectopic pregnancy (pregnancy outside the womb); •• Infertility (inability to get pregnant); •• Long-term pelvic/abdominal ...

  12. TOXIRAE PRO PID

    EPA Science Inventory

    The ToxiRAE Pro PID measures total volatile organic compounds (VOCs) using a photoionization detector (PID). This sensor can be programmed to measure concentrations of a specified compound automatically and has a real time reading of VOC concentrations in parts per million (ppm) ...

  13. Current state and future perspectives of the Latin American Society for Immunodeficiencies (LASID).

    PubMed

    Condino-Neto, A; Sorensen, R U; Gómez Raccio, A C; King, A; Espinosa-Rosales, F J; Franco, J L

    2015-01-01

    Primary immunodeficiencies (PID) are genetic diseases that affect the immune system and for the last 20 years, the Latin American Society for Immunodeficiencies (LASID) has been promoting initiatives in awareness, research, diagnosis, and treatment for the affected patients in Latin America. These initiatives have resulted in the development of programmes such as the LASID Registry (with 4900 patients registered as of January 2014), fellowships in basic and clinical research, PID summer schools, biannual meetings, and scientific reports, amongst others. These achievements highlight the critical role that LASID plays as a scientific organisation in promoting science, research and education in this field in Latin America. However, challenges remain in some of these areas and the Society must envision additional strategies to tackle them for the benefit of the patients. In June 2013, a group of experts in the field met to discuss the contributions of LASID to the initiatives of PID in Latin America, and this article summarises the current state and future perspectives of this society and its role in the advance of PIDs in Latin America.

  14. Temporal association of cellular immune responses with the initial control of viremia in primary human immunodeficiency virus type 1 syndrome.

    PubMed Central

    Koup, R A; Safrit, J T; Cao, Y; Andrews, C A; McLeod, G; Borkowsky, W; Farthing, C; Ho, D D

    1994-01-01

    Virologic and immunologic studies were performed on five patients presenting with primary human immunodeficiency virus type 1 (HIV-1) infection. CD8+ cytotoxic T lymphocyte (CTL) precursors specific for cells expressing antigens of HIV-1 Gag, Pol, and Env were detected at or within 3 weeks of presentation in four of the five patients and were detected in all five patients by 3 to 6 months after presentation. The one patient with an absent initial CTL response had prolonged symptoms, persistent viremia, and low CD4+ T-cell count. Neutralizing antibody activity was absent at the time of presentation in all five patients. These findings suggest that cellular immunity is involved in the initial control of virus replication in primary HIV-1 infection and indicate a role for CTL in protective immunity to HIV-1 in vivo. PMID:8207839

  15. Shared usage of the chemokine receptor CXCR4 by primary and laboratory-adapted strains of feline immunodeficiency virus.

    PubMed

    Richardson, J; Pancino, G; Merat, R; Leste-Lasserre, T; Moraillon, A; Schneider-Mergener, J; Alizon, M; Sonigo, P; Heveker, N

    1999-05-01

    Strains of the feline immunodeficiency virus (FIV) presently under investigation exhibit distinct patterns of in vitro tropism. In particular, the adaptation of FIV for propagation in Crandell feline kidney (CrFK) cells results in the selection of strains capable of forming syncytia with cell lines of diverse species origin. The infection of CrFK cells by CrFK-adapted strains appears to require the chemokine receptor CXCR4 and is inhibited by its natural ligand, stromal cell-derived factor 1alpha (SDF-1alpha). Here we found that inhibitors of CXCR4-mediated infection by human immunodeficiency virus type I (HIV-1), such as the bicyclam AMD3100 and short peptides derived from the amino-terminal region of SDF-1alpha, also blocked infection of CrFK by FIV. Nevertheless, we observed differences in the ranking order of the peptides as inhibitors of FIV and HIV-1 and showed that such differences are related to the species origin of CXCR4 and not that of the viral envelope. These results suggest that, although the envelope glycoproteins of FIV and HIV-1 are substantially divergent, FIV and HIV-1 interact with CXCR4 in a highly similar manner. We have also addressed the role of CXCR4 in the life cycle of primary isolates of FIV. Various CXCR4 ligands inhibited infection of feline peripheral blood mononuclear cells (PBMC) by primary FIV isolates in a concentration-dependent manner. These ligands also blocked the viral transduction of feline PBMC by pseudotyped viral particles when infection was mediated by the envelope glycoprotein of a primary FIV isolate but not by the G protein of vesicular stomatitis virus, indicating that they act at an envelope-mediated step and presumably at viral entry. These findings strongly suggest that primary and CrFK-adapted strains of FIV, despite disparate in vitro tropisms, share usage of CXCR4.

  16. Long-term survival and late deaths after hematopoietic cell transplantation for primary immunodeficiency diseases and inborn errors of metabolism.

    PubMed

    Eapen, Mary; Ahn, Kwang Woo; Orchard, Paul J; Cowan, Morton J; Davies, Stella M; Fasth, Anders; Hassebroek, Anna; Ayas, Mouhab; Bonfim, Carmem; O'Brien, Tracey A; Gross, Thomas G; Horwitz, Mitchell; Horwitz, Edwin; Kapoor, Neena; Kurtzberg, Joanne; Majhail, Navneet; Ringden, Olle; Szabolcs, Paul; Veys, Paul; Baker, K Scott

    2012-09-01

    It is uncertain whether late mortality rates after hematopoietic cell transplantation for severe combined immunodeficiency (SCID), non-SCID primary immunodeficiency diseases (non-SCID PIDD), and inborn errors of metabolism (IEM) return to rates observed in the general population, matched for age, sex, and nationality. We studied patients with SCID (n = 201), non-SCID PIDD (n = 405), and IEM (n = 348) who survived for at least 2 years after transplantation with normal T cell function (SCID) or >95% donor chimerism (non-SCID PIDD and IEM). Importantly, mortality rate was significantly higher in these patients compared with the general population for several years after transplantation. The rate decreased toward the normal rate in patients with SCID and non-SCID PIDD beyond 6 years after transplantation, but not in patients with IEM. Active chronic graft-versus-host disease at 2 years was associated with increased risk of late mortality for all diseases (hazard ratio [HR], 1.87; P = .05). In addition, late mortality was higher in patients with non-SCID PIDD who received T cell-depleted grafts (HR 4.16; P = .007) and in patients with IEM who received unrelated donor grafts (HR, 2.72; P = .03) or mismatched related donor grafts (HR, 3.76; P = .01). The finding of higher mortality rates in these long-term survivors for many years after transplantation confirms the need for long-term surveillance.

  17. Use of intravenous immunoglobulin and adjunctive therapies in the treatment of primary immunodeficiencies: A working group report of and study by the Primary Immunodeficiency Committee of the American Academy of Allergy Asthma and Immunology.

    PubMed

    Yong, Pierre L; Boyle, John; Ballow, Mark; Boyle, Marcia; Berger, Melvin; Bleesing, Jack; Bonilla, Franciso A; Chinen, Javier; Cunninghamm-Rundles, Charlotte; Fuleihan, Ramsay; Nelson, Lois; Wasserman, Richard L; Williams, Kathleen C; Orange, Jordan S

    2010-05-01

    There are an expanding number of primary immunodeficiency diseases (PIDDs), each associated with unique diagnostic and therapeutic complexities. Limited data, however, exist supporting specific therapeutic interventions. Thus, a survey of PIDD management was administered to allergists/immunologists in the United States to identify current perspectives and practices. Among 405 respondents, the majority of key management practices identified were consistent with existing data and guidelines, including the provision of immunoglobulin therapy, immunoglobulin dosing and selective avoidance of live viral vaccines. Practices for which there are little specific data or evidence-based guidance were also examined, including evaluation of IgG trough levels for patients receiving immunoglobulin, use of prophylactic antibiotics and recommendations for complementary/alternative medicine. Here, variability applied to PIDD patients was identified. Differences between practitioners clinically focused upon PIDD and general allergists/immunologists were also identified. Thus, a need for expanded clinical research in PIDD to optimize management and potentially improve outcomes was defined.

  18. Progress and prospects: gene therapy for inherited immunodeficiencies.

    PubMed

    Qasim, W; Gaspar, H B; Thrasher, A J

    2009-11-01

    Haematopoietic stem cell transplantation (HSCT) is now widely used to treat primary immunodeficiencies (PID). For patients with specific disorders (severe combined immunodeficiency (SCID)-X1, adenosine deaminase deficiency (ADA)-SCID, X-chronic granulomatous disease (CGD) and Wiskott-Aldrich Syndrome (WAS)) who lack a suitable human leukocyte antigen (HLA)-matched donor, gene therapy has offered an important alternative treatment option. The success of gene therapy can be attributed, in part, to the selective advantage offered to gene-corrected cells, the avoidance of graft-versus-host disease and to the use of pre-conditioning in patients with chemotherapy to facilitate engraftment of corrected cells. Adverse events have been encountered and this has led to detailed characterization of retroviral vector integration profiles. A new generation of self-inactivating retroviral and lentiviral vectors have been designed to address these safety concerns, and are at an advanced stage of preparation for the next phase of clinical testing.

  19. Genetic Diagnosis Using Whole Exome Sequencing in Common Variable Immunodeficiency

    PubMed Central

    Maffucci, Patrick; Filion, Charles A.; Boisson, Bertrand; Itan, Yuval; Shang, Lei; Casanova, Jean-Laurent; Cunningham-Rundles, Charlotte

    2016-01-01

    Whole exome sequencing (WES) has proven an effective tool for the discovery of genetic defects in patients with primary immunodeficiencies (PIDs). However, success in dissecting the genetic etiology of common variable immunodeficiency (CVID) has been limited. We outline a practical framework for using WES to identify causative genetic defects in these subjects. WES was performed on 50 subjects diagnosed with CVID who had at least one of the following criteria: early onset, autoimmune/inflammatory manifestations, low B lymphocytes, and/or familial history of hypogammaglobulinemia. Following alignment and variant calling, exomes were screened for mutations in 269 PID-causing genes. Variants were filtered based on the mode of inheritance and reported frequency in the general population. Each variant was assessed by study of familial segregation and computational predictions of deleteriousness. Out of 433 variations in PID-associated genes, we identified 17 probable disease-causing mutations in 15 patients (30%). These variations were rare or private and included monoallelic mutations in NFKB1, STAT3, CTLA4, PIK3CD, and IKZF1, and biallelic mutations in LRBA and STXBP2. Forty-two other damaging variants were found but were not considered likely disease-causing based on the mode of inheritance and/or patient phenotype. WES combined with analysis of PID-associated genes is a cost-effective approach to identify disease-causing mutations in CVID patients with severe phenotypes and was successful in 30% of our cohort. As targeted therapeutics are becoming the mainstay of treatment for non-infectious manifestations in CVID, this approach will improve management of patients with more severe phenotypes. PMID:27379089

  20. Impact of antiretroviral pressure on selection of primary human immunodeficiency virus type 1 envelope sequences in vitro

    PubMed Central

    Harada, Shigeyoshi; Yamaguchi, Aki; Boonchawalit, Samatchaya; Yusa, Keisuke; Matsushita, Shuzo

    2013-01-01

    The initiation of drug therapy results in a reduction in the human immunodeficiency virus type 1 (HIV-1) population, which represents a potential genetic bottleneck. The effect of this drug-induced genetic bottleneck on the population dynamics of the envelope (Env) regions has been addressed in several in vivo studies. However, it is difficult to investigate the effect on the env gene of the genetic bottleneck induced not only by entry inhibitors but also by non-entry inhibitors, particularly in vivo. Therefore, this study used an in vitro selection system using unique bulk primary isolates established in the laboratory to observe the effects of the antiretroviral drug-induced bottleneck on the integrase and env genes. Env diversity was decreased significantly in one primary isolate [KP-1, harbouring both CXCR4 (X4)- and CCR5 (R5)-tropic variants] when passaged in the presence or absence of raltegravir (RAL) during in vitro selection. Furthermore, the RAL-selected KP-1 variant had a completely different Env sequence from that in the passage control (particularly evident in the gp120, V1/V2 and V4-loop regions), and a different number of potential N-glycosylation sites. A similar pattern was also observed in other primary isolates when using different classes of drugs. This is the first study to explore the influence of anti-HIV drugs on bottlenecks in bulk primary HIV isolates with highly diverse Env sequences using in vitro selection. PMID:23288425

  1. Herpes simplex virus type 2 infection increases human immunodeficiency virus type 1 entry into human primary macrophages.

    PubMed

    Sartori, Elena; Calistri, Arianna; Salata, Cristiano; Del Vecchio, Claudia; Palù, Giorgio; Parolin, Cristina

    2011-04-12

    Epidemiological and clinical data indicate that genital ulcer disease (GUD) pathogens are associated with an increased risk of human immunodeficiency virus type 1 (HIV-1) acquisition and/or transmission. Among them, genital herpes simplex virus type 2 (HSV-2) seems to play a relevant role. Indeed, the ability of HSV-2 to induce massive infiltration at the genital level of cells which are potential targets for HIV-1 infection may represent one of the mechanisms involved in this process. Here we show that infection of human primary macrophages (MDMs) by HSV-2 results in an increase of CCR5 expression levels on cell surface and allows higher efficiency of MDMs to support entry of R5 HIV-1 strains. This finding could strengthen, at the molecular level, the evidence linking HSV-2 infection to an increased susceptibility to HIV-1 acquisition.

  2. Primary Radiation Therapy for Head-and-Neck Cancer in the Setting of Human Immunodeficiency Virus

    SciTech Connect

    Klein, Emily A.; Guiou, Michael; Farwell, D. Gregory; Luu, Quang; Lau, Derick H.; Stuart, Kerri; Vaughan, Andrew; Vijayakumar, Srinivasan; Chen, Allen M.

    2011-01-01

    Purpose: To analyze outcomes after radiation therapy for head-and-neck cancer among a cohort of patients with human immunodeficiency virus (HIV). Methods and Materials: The medical records of 12 patients with serologic evidence of HIV who subsequently underwent radiation therapy to a median dose of 68 Gy (range, 64-72 Gy) for newly diagnosed squamous cell carcinoma of the head and neck were reviewed. Six patients (50%) received concurrent chemotherapy. Intensity-modulated radiotherapy was used in 6 cases (50%). All patients had a Karnofsky performance status of 80 or 90. Nine patients (75%) were receiving antiretroviral therapies at the time of treatment, and the median CD4 count was 460 (range, 266-800). Toxicity was graded according to the Radiation Therapy Oncology Group / European Organization for the Treatment of Cancer toxicity criteria. Results: The 3-year estimates of overall survival and local-regional control were 78% and 92%, respectively. Acute Grade 3+ toxicity occurred in 7 patients (58%), the most common being confluent mucositis (5 patients) and moist skin desquamation (4 patients). Two patients experienced greater than 10% weight loss, and none experienced more than 15% weight loss from baseline. Five patients (42%) experienced treatment breaks in excess of 10 cumulative days, although none required hospitalization. There were no treatment-related fatalities. Conclusions: Radiation therapy for head-and-neck cancer seems to be relatively well tolerated among appropriately selected patients with HIV. The observed rates of toxicity were comparable to historical controls without HIV.

  3. Pattern recognitions receptors in immunodeficiency disorders.

    PubMed

    Mortaz, Esameil; Adcock, Ian M; Tabarsi, Payam; Darazam, Ilad Alavi; Movassaghi, Masoud; Garssen, Johan; Jamaati, Hamidreza; Velayati, Aliakbar

    2017-01-14

    Pattern recognition receptors (PRRs) recognize common microbial or host-derived macromolecules and have important roles in early activation and response of the immune system. Initiation of the innate immune response starts with the recognition of microbial structures called pathogen associated molecular patterns (PAMPs). Recognition of PAMPs is performed by germline-encoded receptors expressed mainly on immune cells termed pattern recognition receptors (PRRs). Several classes of pattern recognition receptors (PRRs) are involved in the pathogenesis of diseases, including Toll-like receptors (TLRs), C-type lectin receptors (CLRs), and Nod-like receptors (NLRs). Patients with primary immune deficiencies (PIDs) affecting TLR signaling can elucidate the importance of these proteins in the human immune system. Defects in interleukin-1 receptor-associated kinase-4 and myeloid differentiation factor 88 (MyD88) lead to susceptibility to infections with bacteria, while mutations in nuclear factor-κB essential modulator (NEMO) and other downstream mediators generally induce broader susceptibility to bacteria, viruses, and fungi. In contrast, TLR3 signaling defects are associated with susceptibility to herpes simplex virus type 1 encephalitis. Other PIDs induce functional alterations of TLR signaling pathways, such as common variable immunodeficiency in which plasmacytoid dendritic cell defects enhance defective responses of B cells to shared TLR agonists. Altered TLR responses to TLR2 and 4 agonists are seen in chronic granulomatous disease (CGD) and X-linked agammaglobulinemia (XLA). Enhanced TLR responses, meanwhile, are seen for TLRs 5 and 9 in CGD, TLRs 4, 7/8, and 9 in XLA, TLRs 2 and 4 in hyper IgE syndrome (HIES), and for most TLRs in adenosine deaminase deficiency. In this review we provide the reader with an update on the role of TLRs and downstream signaling pathways in PID disorders.

  4. Recurrent Infections May Signal Immunodeficiencies

    MedlinePlus

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  5. Dual tropism for macrophages and lymphocytes is a common feature of primary human immunodeficiency virus type 1 and 2 isolates.

    PubMed Central

    Valentin, A; Albert, J; Fenyö, E M; Asjö, B

    1994-01-01

    We have investigated the ability of human immunodeficiency virus type 1 (HIV-1) and HIV-2 isolates to infect and replicate in primary human macrophages. Monocytes from blood donors were allowed to differentiate into macrophages by culture in the presence of autologous lymphocytes and human serum for 5 days before infection. A panel of 70 HIV-1 and 12 HIV-2 isolates were recovered from seropositive individuals with different severities of HIV infection. A majority of isolates (55 HIV-1 and all HIV-2) were obtained from peripheral blood mononuclear cells, but isolates from cerebrospinal fluid, monocytes, brain tissue, plasma, and purified CD4+ lymphocytes were also included. All isolates were able to infect monocyte-derived macrophages, even though the replicative capacity of the isolates varied. Interestingly, isolates with a rapid/high, syncytium-inducing phenotype did not differ from slow/low, non-syncytium-inducing isolates in their ability to replicate in monocyte-derived macrophages. Others have reported that rapid/high, syncytium-inducing isolates have a reduced ability to infect and replicate in monocytes. However, different methods to isolate and culture the monocytes/macrophages were used in these studies and our study. Thus, the ability of HIV isolates to replicate in monocytes/macrophages appears to be strongly influenced by the isolation and culture procedures. It remains to be determined which culture procedure is more relevant for the in vivo situation. PMID:7521920

  6. Long-lasting production of new T and B cells and T-cell repertoire diversity in patients with primary immunodeficiency who had undergone stem cell transplantation: a single-centre experience.

    PubMed

    Valotti, Monica; Sottini, Alessandra; Lanfranchi, Arnalda; Bolda, Federica; Serana, Federico; Bertoli, Diego; Giustini, Viviana; Tessitore, Marion Vaglio; Caimi, Luigi; Imberti, Luisa

    2014-01-01

    Levels of Kappa-deleting recombination excision circles (KRECs), T-cell receptor excision circles (TRECs), and T-cell repertoire diversity were evaluated in 1038 samples of 124 children with primary immunodeficiency, of whom 102 (54 with severe combined immunodeficiency and 48 with other types of immunodeficiency) underwent hematopoietic stem cell transplantation. Twenty-two not transplanted patients with primary immunodeficiency were used as controls. Only data of patients from whom at least five samples were sent to the clinical laboratory for routine monitoring of lymphocyte reconstitutions were included in the analysis. The mean time of the follow-up was 8 years. The long-lasting posttransplantation kinetics of KREC and TREC production occurred similarly in patients with severe combined immunodeficiency and with other types of immunodeficiency and, in both groups, the T-cell reconstitution was more efficient than in nontransplanted children. Although thymic output decreased in older transplanted patients, the degree of T-cell repertoire diversity, after an initial increase, remained stable during the observation period. However, the presence of graft-versus-host disease and ablative conditioning seemed to play a role in the time-related shaping of T-cell repertoire. Overall, our data suggest that long-term B- and T-cell reconstitution was equally achieved in children with severe combined immunodeficiency and with other types of primary immunodeficiency.

  7. Dynamic PID loop control

    SciTech Connect

    Pei, L.; Klebaner, A.; Theilacker, J.; Soyars, W.; Martinez, A.; Bossert, R.; DeGraff, B.; Darve, C.; /Fermilab

    2011-06-01

    The Horizontal Test Stand (HTS) SRF Cavity and Cryomodule 1 (CM1) of eight 9-cell, 1.3GHz SRF cavities are operating at Fermilab. For the cryogenic control system, how to hold liquid level constant in the cryostat by regulation of its Joule-Thompson JT-valve is very important after cryostat cool down to 2.0 K. The 72-cell cryostat liquid level response generally takes a long time delay after regulating its JT-valve; therefore, typical PID control loop should result in some cryostat parameter oscillations. This paper presents a type of PID parameter self-optimal and Time-Delay control method used to reduce cryogenic system parameters oscillation.

  8. WS/PIDS: standard interoperable PIDS in web services environments.

    PubMed

    Vasilescu, E; Dorobanţu, M; Govoni, S; Padh, S; Mun, S K

    2008-01-01

    An electronic health record depends on the consistent handling of people's identities within and outside healthcare organizations. Currently, the Person Identification Service (PIDS), a CORBA specification, is the only well-researched standard that meets these needs. In this paper, we introduce WS/PIDS, a PIDS specification for Web Services (WS) that closely matches the original PIDS and improves on it by providing explicit support for medical multimedia attributes. WS/PIDS is currently supported by a test implementation, layered on top of a PIDS back-end, with Java- and NET-based, and Web clients. WS/PIDS is interoperable among platforms; it preserves PIDS semantics to a large extent, and it is intended to be fully compliant with established and emerging WS standards. The specification is open source and immediately usable in dynamic clinical systems participating in grid environments. WS/PIDS has been tested successfully with a comprehensive set of use cases, and it is being used in a clinical research setting.

  9. Dynamic Modulation of Expression of Lentiviral Restriction Factors in Primary CD4(+) T Cells following Simian Immunodeficiency Virus Infection.

    PubMed

    Rahmberg, Andrew R; Rajakumar, Premeela A; Billingsley, James M; Johnson, R Paul

    2017-04-01

    Although multiple restriction factors have been shown to inhibit HIV/SIV replication, little is known about their expression in vivo Expression of 45 confirmed and putative HIV/SIV restriction factors was analyzed in CD4(+) T cells from peripheral blood and the jejunum in rhesus macaques, revealing distinct expression patterns in naive and memory subsets. In both peripheral blood and the jejunum, memory CD4(+) T cells expressed higher levels of multiple restriction factors compared to naive cells. However, relative to their expression in peripheral blood CD4(+) T cells, jejunal CCR5(+) CD4(+) T cells exhibited significantly lower expression of multiple restriction factors, including APOBEC3G, MX2, and TRIM25, which may contribute to the exquisite susceptibility of these cells to SIV infection. In vitro stimulation with anti-CD3/CD28 antibodies or type I interferon resulted in upregulation of distinct subsets of multiple restriction factors. After infection of rhesus macaques with SIVmac239, the expression of most confirmed and putative restriction factors substantially increased in all CD4(+) T cell memory subsets at the peak of acute infection. Jejunal CCR5(+) CD4(+) T cells exhibited the highest levels of SIV RNA, corresponding to the lower restriction factor expression in this subset relative to peripheral blood prior to infection. These results illustrate the dynamic modulation of confirmed and putative restriction factor expression by memory differentiation, stimulation, tissue microenvironment and SIV infection and suggest that differential expression of restriction factors may play a key role in modulating the susceptibility of different populations of CD4(+) T cells to lentiviral infection.IMPORTANCE Restriction factors are genes that have evolved to provide intrinsic defense against viruses. HIV and simian immunodeficiency virus (SIV) target CD4(+) T cells. The baseline level of expression in vivo and degree to which expression of restriction factors is

  10. The NF-kappa B binding site is necessary for efficient replication of simian immunodeficiency virus of macaques in primary macrophages but not in T cells in vitro.

    PubMed Central

    Bellas, R E; Hopkins, N; Li, Y

    1993-01-01

    We demonstrate here that the nuclear factor-kappa B (NF-kappa B) binding site in the simian immunodeficiency virus (SIVmac) long terminal repeat is essential for efficient virus replication in primary alveolar macrophages but dispensable for efficient replication in primary T cells. Mutation of the NF-kappa B site does not seriously impair replication of a T-cell-tropic SIVmac239 or a macrophagetropic SIVmacEm* in peripheral blood lymphocytes or established CD4+ cell lines; however, mutation of the NF-kappa B site prevents efficient SIVmacEm* replication in primary alveolar macrophages. These data suggest that efficient replication in primary macrophages requires both envelope and long terminal repeat determinants. Images PMID:8474179

  11. Autoimmunity and Immunodeficiency.

    PubMed

    Dosanjh, Amrita

    2015-11-01

    The references provided include data from evidence A and B studies based on the relevant populations. Because many primary immunodeficiencies associated with autoimmune diseases are rare, illustrative cases (evidence D) also are referenced. On the basis of level A evidence, immunoglobulin A deficiency is the most common primary immunodeficiency and is associated with defective mucosal immunity and autoimmune disease. On the basis of strong evidence (level A), Wiskott Aldrich syndrome presents early in life and is associated with autoimmune arthritis and anemia. On the basis of strong evidence in the literature, a number of primary immunodeficiencies are associated with defects in T regulatory cell number and development, cytokine aberrancies, and, as a consequence, production of autoantibodies. On the basis of strong evidence (level A) and case reports (level D), complement deficiency can be associated with autoimmune disease, most notably systemic lupus erythematosus.

  12. Immunomodulation and immunodeficiency.

    PubMed

    Foster, Aiden P

    2004-04-01

    This article briefly reviews the concepts of immunodeficiency and immunomodulation as they relate to selected skin diseases in the dog and cat. Immunodeficiency states are uncommon and may be associated with a subnormal or down-regulated immune system, including humoral deficiencies, such as IgA, and abnormal lymphocyte or neutrophil function. Establishing a causal relationship between a skin disease and presumed immunodeficient state has been difficult due to the rarity of such conditions, and the limited nature of the techniques used to characterise the immune system response. Severe combined immunodeficiency in dogs is a well characterised primary immunodeficiency state involving lymphocytes; retrovirus infection in cats may lead to an acquired immunodeficient state with some association with certain dermatological conditions although it remains unclear that infection is causally linked with disease. Immunomodulation usually implies stimulating the immune system along a beneficial pathway. Such a therapeutic approach may involve a wide variety of agents, for example intravenous immunoglobulin. There are few randomised controlled trials with veterinary patients that unequivocally demonstrate beneficial responses to immunomodulatory agents. Interferons are cytokines of major interest in human and veterinary medicine for their antiviral, anti-tumour and immunomodulatory effects. The advent of veterinary-licensed products containing recombinant interferon may enable demonstration of the efficacy of interferons for conditions such as canine papillomatosis and feline eosinophilic granuloma complex. Canine pyoderma has been treated with a number of presumed immunomodulatory agents with limited success. With more detailed knowledge of the pathogenesis of pyoderma it may be possible to develop efficacious immunomodulators.

  13. Mental health in primary human immunodeficiency virus care in South Africa: a study of provider knowledge, attitudes, and practice.

    PubMed

    Mall, Sumaya; Sorsdahl, Katherine; Struthers, Helen; Joska, John A

    2013-03-01

    The role of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome care providers in detecting mental disorders in their patients is important to strengthen retention in antiretroviral care programs as well as adherence to treatment. A convenience sample of 66 HIV service providers were asked to participate in the study before attending a workshop. Two vignettes portraying HIV patients with depression and substance use (specifically problematic alcohol use) were presented to respondents to investigate their mental health literacy and attitudes toward mental disorders. Results indicated that 50% of respondents recognized depression (57% of professionals and 39% of nonprofessionals) and 37% recognized mental illness (28% of professionals and 31% of nonprofessionals). Psychosocial stress was reported more frequently than medical etiologies as a possible cause of mental disorders. Seeking help from a health professional in the form of psychotherapy was often endorsed as an effective treatment option. Further effort is required to educate HIV service providers about the psychobiological underpinnings of psychiatric disorders and effective treatments.

  14. PID Tuning Using Extremum Seeking

    SciTech Connect

    Killingsworth, N; Krstic, M

    2005-11-15

    Although proportional-integral-derivative (PID) controllers are widely used in the process industry, their effectiveness is often limited due to poor tuning. Manual tuning of PID controllers, which requires optimization of three parameters, is a time-consuming task. To remedy this difficulty, much effort has been invested in developing systematic tuning methods. Many of these methods rely on knowledge of the plant model or require special experiments to identify a suitable plant model. Reviews of these methods are given in [1] and the survey paper [2]. However, in many situations a plant model is not known, and it is not desirable to open the process loop for system identification. Thus a method for tuning PID parameters within a closed-loop setting is advantageous. In relay feedback tuning [3]-[5], the feedback controller is temporarily replaced by a relay. Relay feedback causes most systems to oscillate, thus determining one point on the Nyquist diagram. Based on the location of this point, PID parameters can be chosen to give the closed-loop system a desired phase and gain margin. An alternative tuning method, which does not require either a modification of the system or a system model, is unfalsified control [6], [7]. This method uses input-output data to determine whether a set of PID parameters meets performance specifications. An adaptive algorithm is used to update the PID controller based on whether or not the controller falsifies a given criterion. The method requires a finite set of candidate PID controllers that must be initially specified [6]. Unfalsified control for an infinite set of PID controllers has been developed in [7]; this approach requires a carefully chosen input signal [8]. Yet another model-free PID tuning method that does not require opening of the loop is iterative feedback tuning (IFT). IFT iteratively optimizes the controller parameters with respect to a cost function derived from the output signal of the closed-loop system, see [9

  15. A Comparative Study of Intravenous Immunoglobulin and Subcutaneous Immunoglobulin in Adult Patients with Primary Immunodeficiency Diseases: A Systematic Review and Meta-Analysis.

    PubMed

    Shabaninejad, Hosein; Asgharzadeh, Asra; Rezaei, Nima; Rezapoor, Aziz

    2016-01-01

    Subcutaneous immunoglobulin (SCIG) is a new therapeutic procedure for patients with primary immunodeficiency (PI). This research is a systematic review of studies on the efficacy and safety of intravenous immunoglobulin (IVIG) and SCIG in adult patients with PI. This study includes a systematic review of cohorts and randomized clinical trials (24 articles) from 5 databases with no time limits. Random effects meta-analysis was performed for outcomes such as efficacy and safety. Standard mean difference (SMD) of serum immunoglobulin level was equal to 0.336 (P <0.01; 0.205-0.467) and the odds ratio (OR) of side effects was 0.497 (P=0.1; 0.180-1.371). The results indicate that SCIG leads to a higher level of immunoglobulin and a reduction in side effects but shows the same infection rate as IVIG. Our analysis shows that shifting from IVIG to SCIG therapy can have clinical benefits for PI patients.

  16. Primary immunodeficiency in combination with transverse upper limb defect and anal atresia in a 34-year-old patient with Jacobsen syndrome.

    PubMed

    von Bubnoff, Dagmar; Kreiss-Nachtsheim, Martina; Novak, Natalija; Engels, Eva; Engels, Hartmut; Behrend, Claudia; Propping, Peter; de la Salle, Henri; Bieber, Thomas

    2004-04-30

    We describe a 34-year-old male patient with Jacobsen syndrome associated with a broad spectrum of anomalies and an increased susceptibility to infections. Features commonly seen in Jacobsen syndrome were short stature, mental retardation, congenital heart disease, cryptorchidism, strabismus, distal hypospadia glandis, and mild thrombocytopenia. Chromosome analysis disclosed a mosaic 46,XY,del(11)(q24.1)/46,XY karyotype with a very low percentage of normal cells. In addition, transverse upper limb defect, imperforate anus, and hearing impairment were noted. Cellular anomalies include functional impairment and deficiency of T-helper cells, and a low serum immunoglobulin M (IgM)-level. The presence of a transverse limb defect and primary immunodeficiency has not been reported previously in Jacobsen syndrome.

  17. Common variable immunodeficiency: 20-yr experience at a single centre.

    PubMed

    Llobet, M Pilar; Soler-Palacin, Pere; Detkova, Drahomira; Hernández, Manuel; Caragol, Isabel; Espanol, Teresa

    2009-03-01

    Common variable immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency. It can present at any age in patients with a history of recurrent bacterial infections, with or without a family history of other primary immunodeficiencies (PID), and shows a wide range of clinical manifestations and immunological data. Diagnosis is based on low IgG, IgM and/or IgA levels. Delayed diagnosis and therapy can lead to bronchiectasis and malabsorption. The aim of this study was to describe a paediatric population diagnosed of CVID and its evolution in the population. Memory B-cell (MB) classification carried out in these patients was correlated with clinical manifestations and outcome. Clinical and immunological data of 22 CVID children under 18 yr treated at our centre between 1985 and 2005 are presented. Immunological studies included those for diagnosis and MB quantification. Differences in form of presentation, familial incidence and MB classification were reviewed. A statistical descriptive analysis was made. Infections were the commonest manifestation, affecting mainly respiratory (19/22) and gastrointestinal (10/22) tracts. Bronchiectasis was present in seven cases, and detected prior to CVID diagnosis in five. Replacement therapy led to a significant reduction in the number of infections. Severe complications appeared mostly in patients without MB. Patients of the same family share the same MB group. Family members had also been diagnosed of CVID in seven cases. Early diagnosis and therapy are essential to improve outcome in these patients. MB studies are useful in children to orient prognosis and further genetic studies.

  18. The case for a national service for primary immune deficiency disorders in New Zealand.

    PubMed

    Ameratunga, Rohan; Steele, Richard; Jordan, Anthony; Preece, Kahn; Barker, Russell; Brewerton, Maia; Lindsay, Karen; Sinclair, Jan; Storey, Peter; Woon, See-Tarn

    2016-06-10

    Primary immune deficiency disorders (PIDs) are rare conditions for which effective treatment is available. It is critical these patients are identified at an early stage to prevent unnecessary morbidity and mortality. Treatment of these disorders is expensive and expert evaluation and ongoing management by a clinical immunologist is essential. Until recently there has been a major shortage of clinical immunologists in New Zealand. While the numbers of trained immunologists have increased in recent years, most are located in Auckland. The majority of symptomatic PID patients require life-long immunoglobulin replacement. Currently there is a shortage of subcutaneous and intravenous immunoglobulin (SCIG/IVIG) in New Zealand. A recent audit by the New Zealand Blood Service (NZBS) showed that compliance with indications for SCIG/IVIG treatment was poor in District Health Boards (DHBs) without an immunology service. The NZBS audit has shown that approximately 20% of annual prescriptions for SCIG/IVIG, costing $6M, do not comply with UK or Australian guidelines. Inappropriate use may have contributed to the present shortage of SCIG/IVIG necessitating importation of the product. This is likely to have resulted in a major unnecessary financial burden to each DHB. Here we present the case for a national service responsible for the tertiary care of PID patients and oversight for immunoglobulin use for primary and non-haematological secondary immunodeficiencies. We propose that other PIDs, including hereditary angioedema, are integrated into a national PID service. Ancillary services, including the customised genetic testing service, and research are also an essential component of an integrated national PID service and are described in this review. As we show here, a hub-and-spoke model for a national service for PIDs would result in major cost savings, as well as improved patient care. It would also allow seamless transition from paediatric to adult services.

  19. Isolation of CD4-independent primary human immunodeficiency virus type 1 isolates that are syncytium inducing and acutely cytopathic for CD8+ lymphocytes.

    PubMed

    Zerhouni, Bouchra; Nelson, Julie A E; Saha, Kunal

    2004-02-01

    Previous studies have established the existence of CD4-independent simian immunodeficiency virus, human immunodeficiency virus type 2 (HIV-2), and laboratory strains of HIV-1. However, whether CD4-independent viruses may also exist in HIV-1-infected patients has remained unclear. We have recently reported the isolation of viruses from an AIDS patient that were able to infect CD8(+) cells independent of CD4, using CD8 as a receptor. Using a similar approach, here we examined viruses from 12 randomly selected patients (obtained from the AIDS Research and Reference Program, National Institutes of Health) for the presence of CD4-independent HIV-1. CD4-independent variants were isolated from infected CD8(+) cells from the viral quasispecies of 7 of 12 patients. The CD4-independent isolates were able to infect primary CD8(+) cells as well as a CD4(-) CD8(+) T-cell line. Soluble CD4 and blocking anti-CD4 or -CD8 antibody had no effect on infection of CD8(+) cells. Remarkably, two of the seven CD4-independent isolates, but not their parental bulk viruses, induced syncytia and caused acute death of infected CD8(+) cells. Some of the CD4-independent variants were also able to infect U87 cells that were negative for CD4, CD8, and common HIV coreceptors, suggesting a novel entry mechanism for these isolates. The CD4-independent isolates were derived from adults and children infected with subtypes A, B, and D. Although no common motif for CD4 independence was found, novel sequence changes were observed in critical areas of the envelopes of the CD4-independent viruses. These results demonstrate that HIV-1-infected patients can frequently harbor viruses that are able to mediate CD4-independent infection of CD8(+) cells. In addition, this study also provides evidence of primary HIV-1 variants that are syncytium inducing and acutely cytopathic for CD8(+) lymphocytes.

  20. Envelope Glycoprotein Incorporation, Not Shedding of Surface Envelope Glycoprotein (gp120/SU), Is the Primary Determinant of SU Content of Purified Human Immunodeficiency Virus Type 1 and Simian Immunodeficiency Virus

    PubMed Central

    Chertova, Elena; Bess, Jr., Julian W.; Crise, Bruce J.; Sowder II, Raymond C.; Schaden, Terra M.; Hilburn, Joanne M.; Hoxie, James A.; Benveniste, Raoul E.; Lifson, Jeffrey D.; Henderson, Louis E.; Arthur, Larry O.

    2002-01-01

    Human immunodeficiency virus type 1 (HIV-1) and simian immunodeficiency virus (SIV) particles typically contain small amounts of the surface envelope protein (SU), and this is widely believed to be due to shedding of SU from mature virions. We purified proteins from HIV-1 and SIV isolates using procedures which allow quantitative measurements of viral protein content and determination of the ratios of gag- and env-encoded proteins in virions. All of the HIV-1 and most of the SIV isolates examined contained low levels of envelope proteins, with Gag:Env ratios of approximately 60:1. Based on an estimate of 1,200 to 2,500 Gag molecules per virion, this corresponds to an average of between 21 and 42 SU molecules, or between 7 and 14 trimers, per particle. In contrast, some SIV isolates contained levels of SU at least 10-fold greater than SU from HIV-1 isolates. Quantification of relative amounts of SU and transmembrane envelope protein (TM) provides a means to assess the impact of SU shedding on virion SU content, since such shedding would be expected to result in a molar excess of TM over SU on virions that had shed SU. With one exception, viruses with sufficient SU and TM to allow quantification were found to have approximately equivalent molar amounts of SU and TM. The quantity of SU associated with virions and the SU:TM ratios were not significantly changed during multiple freeze-thaw cycles or purification through sucrose gradients. Exposure of purified HIV-1 and SIV to temperatures of 55°C or greater for 1 h resulted in loss of most of the SU from the virus but retention of TM. Incubation of purified virus with soluble CD4 at 37°C resulted in no appreciable loss of SU from either SIV or HIV-1. These results indicate that the association of SU and TM on the purified virions studied is quite stable. These findings suggest that incorporation of SU-TM complexes into the viral membrane may be the primary factor determining the quantity of SU associated with SIV and

  1. Multivariable PID control by decoupling

    NASA Astrophysics Data System (ADS)

    Garrido, Juan; Vázquez, Francisco; Morilla, Fernando

    2016-04-01

    This paper presents a new methodology to design multivariable proportional-integral-derivative (PID) controllers based on decoupling control. The method is presented for general n × n processes. In the design procedure, an ideal decoupling control with integral action is designed to minimise interactions. It depends on the desired open-loop processes that are specified according to realisability conditions and desired closed-loop performance specifications. These realisability conditions are stated and three common cases to define the open-loop processes are studied and proposed. Then, controller elements are approximated to PID structure. From a practical point of view, the wind-up problem is also considered and a new anti-wind-up scheme for multivariable PID controller is proposed. Comparisons with other works demonstrate the effectiveness of the methodology through the use of several simulation examples and an experimental lab process.

  2. Human Immunodeficiency Virus Type 1 gp120 Induces Apoptosis in Human Primary Neurons through Redox-Regulated Activation of Neutral Sphingomyelinase

    PubMed Central

    Jana, Arundhati; Pahan, Kalipada

    2007-01-01

    Human immunodeficiency virus type 1 (HIV-1) infection is known to cause disorders of the CNS, including HIV-associated dementia (HAD). HIV-1 coat protein gp120 (glycoprotein 120) induces neuronal apoptosis and has been implicated in the pathogenesis of HAD. However, the mechanism by which gp120 causes neuronal apoptosis is poorly understood. The present study underlines the importance of gp120 in inducing the production of ceramide, an important inducer of apoptosis, in human primary neurons. gp120 induced the activation of sphingomyelinases (primarily the neutral one) and the production of ceramide in primary neurons. Antisense knockdown of neutral (NSMase) but not acidic (ASMase) sphingomyelinase markedly inhibited gp120-mediated apoptosis and cell death of primary neurons, suggesting that the activation of NSMase but not ASMase plays an important role in gp120-mediated neuronal apoptosis. Similarly, the HIV-1 regulatory protein Tat also induced neuronal cell death via NSMase. Furthermore, gp120-induced production of ceramide was redox sensitive, because reactive oxygen species were involved in the activation of NSMase but not ASMase. gp120 coupled CXCR4 (CXC chemokine receptor 4) to induce NADPH oxidase-mediated production of superoxide radicals in neurons, which was involved in the activation of NSMase but not ASMase. These studies suggest that gp120 may induce neuronal apoptosis in the CNS of HAD patients through the CXCR4–NADPH oxidase–superoxide–NSMase–ceramide pathway. PMID:15509740

  3. Allogeneic hematopoietic cell transplantation for primary immune deficiency diseases: current status and critical needs.

    PubMed

    Griffith, Linda M; Cowan, Morton J; Kohn, Donald B; Notarangelo, Luigi D; Puck, Jennifer M; Schultz, Kirk R; Buckley, Rebecca H; Eapen, Mary; Kamani, Naynesh R; O'Reilly, Richard J; Parkman, Robertson; Roifman, Chaim M; Sullivan, Kathleen E; Filipovich, Alexandra H; Fleisher, Thomas A; Shearer, William T

    2008-12-01

    Allogeneic hematopoietic cell transplantation (HCT) has been used for 40 years to ameliorate or cure primary immune deficiency (PID) diseases, including severe combined immunodeficiency (SCID) and non-SCID PID. There is a critical need for evaluation of the North American experience of different HCT approaches for these diseases to identify best practices and plan future investigative clinical trials. Our survey of incidence and prevalence of PID in North American practice sites indicates that such studies are feasible. A conference of experts in HCT treatment of PID has recommended (1) a comprehensive cross-sectional and retrospective analysis of HCT survivors with SCID; (2) a prospective study of patients with SCID receiving HCT, with comparable baseline and follow-up testing across participating centers; (3) a pilot study of newborn screening for SCID to identify affected infants before compromise by infection; and (4) studies of the natural history of disease in patients who do or do not receive HCT for the non-SCID diseases of Wiskott-Aldrich syndrome and chronic granulomatous disease. To accomplish these goals, collaboration by a consortium of institutions in North America is proposed. Participation of immunologists and HCT physicians having interest in PID and experts in laboratory methods, clinical outcomes assessment, databases, and analysis will be required for the success of these studies.

  4. Efficient Transduction of Human and Rhesus Macaque Primary T Cells by a Modified Human Immunodeficiency Virus Type 1-Based Lentiviral Vector.

    PubMed

    He, Huan; Xue, Jing; Wang, Weiming; Liu, Lihong; Ye, Chaobaihui; Cong, Zhe; Kimata, Jason T; Qin, Chuan; Zhou, Paul

    2017-03-01

    Human immunodeficiency virus type 1 (HIV-1)-based lentiviral vectors efficiently transduce genes to human, but not rhesus, primary T cells and hematopoietic stem cells (HSCs). The poor transduction of HIV-1 vectors to rhesus cells is mainly due to species-specific restriction factors such as rhesus TRIM5α. Previously, several strategies to modify HIV-1 vectors were developed to overcome rhesus TRIM5α restriction. While the modified HIV-1 vectors efficiently transduce rhesus HSCs, they remain suboptimal for rhesus primary T cells. Recently, HIV-1 variants that encode combinations of LNEIE mutations in capsid (CA) protein and SIVmac239 Vif were found to replicate efficiently in rhesus primary T cells. Thus, the present study tested whether HIV-1 vectors packaged by a packaging construct containing these CA substitutions could efficiently transduce both human and rhesus primary CD4 T cells. To accomplish this, LNEIE mutations were made in the packaging construct CEMΔ8.9, and recombinant HIV-1 vectors packaged by Δ8.9 WT or Δ8.9 LNEIE were generated. Transduction rates, CA stability, and vector integration in CEMss-CCR5 and CEMss-CCR5-rhTRIM5α/green fluorescent protein cells, as well as transduction rates in human and rhesus primary CD4 T cells by Δ8.9 WT or Δ8.9 LNEIE-packaged HIV-1 vectors, were compared. Finally, the influence of rhesus TRIM5α variations in transduction rates to primary CD4 T cells from a cohort of 37 Chinese rhesus macaques was studied. While it maintains efficient transduction for human T-cell line and primary CD4 T cells, Δ8.9 LNEIE-packaged HIV-1 vector overcomes rhesus TRIM5α-mediated CA degradation, resulting in significantly higher transduction efficiency of rhesus primary CD4 T cells than Δ8.9 WT-packaged HIV-1 vector. Rhesus TRIM5α variations strongly influence transduction efficiency of rhesus primary CD4 T cells by both Δ8.9 WT or Δ8.9 LNEIE-packaged HIV-1 vectors. Thus, it is concluded that Δ8.9 LNEIE-packaged HIV-1

  5. Pelvic Inflammatory Disease (PID) Treatment and Care

    MedlinePlus

    ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ...

  6. Pelvic Inflammatory Disease (PID) Fact Sheet

    MedlinePlus

    ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ... Pelvic Inflammatory Disease (PID) STDs & Infertility STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy Reproductive Health ...

  7. Primary Immune Deficiency Treatment Consortium (PIDTC) Report

    PubMed Central

    Griffith, Linda M.; Cowan, Morton J.; Notarangelo, Luigi D.; Kohn, Donald B.; Puck, Jennifer M.; Pai, Sung-Yun; Ballard, Barbara; Bauer, Sarah C.; Bleesing, Jack J. H.; Boyle, Marcia; Brower, Amy; Buckley, Rebecca H.; van der Burg, Mirjam; Burroughs, Lauri M.; Candotti, Fabio; Cant, Andrew J.; Chatila, Talal; Cunningham-Rundles, Charlotte; Dinauer, Mary C.; Dvorak, Christopher C.; Filipovich, Alexandra H.; Fleisher, Thomas A.; Gaspar, Hubert Bobby; Gungor, Tayfun; Haddad, Elie; Hovermale, Emily; Huang, Faith; Hurley, Alan; Hurley, Mary; Iyengar, Sumathi; Kang, Elizabeth M.; Logan, Brent R.; Long-Boyle, Janel R.; Malech, Harry L.; McGhee, Sean A.; Modell, Fred; Modell, Vicki; Ochs, Hans D.; O'Reilly, Richard J.; Parkman, Robertson; Rawlings, David J.; Routes, John M.; Shearer, William T.; Small, Trudy N.; Smith, Heather; Sullivan, Kathleen E.; Szabolcs, Paul; Thrasher, Adrian; Torgerson, Troy R.; Veys, Paul; Weinberg, Kenneth; Zuniga-Pflucker, Juan Carlos

    2013-01-01

    The Primary Immune Deficiency Treatment Consortium (PIDTC) is a network of 33 centers in North America that study the treatment of rare and severe primary immunodeficiency diseases (PID). Current protocols address the natural history of patients treated for Severe Combined Immunodeficiency (SCID), Wiskott-Aldrich Syndrome and Chronic Granulomatous Disease through retrospective, prospective and cross-sectional studies. The PIDTC additionally seeks to: encourage training of junior investigators; establish partnerships with European and other International colleagues; work with patient advocacy groups to promote community awareness; and conduct pilot demonstration projects. Future goals include the conduct of prospective treatment studies to determine optimal therapies for PID. To date, the PIDTC has funded two pilot projects: newborn screening for SCID in Navajo Native Americans; and B cell reconstitution in SCID patients following hematopoietic stem cell transplantation. Ten junior investigators have received grant awards. The PIDTC Annual Scientific Workshop has brought together consortium members, outside speakers, patient advocacy groups, and young investigators and trainees to report progress of the protocols and discuss common interests and goals, including new scientific developments and future directions of clinical research. Here we report the progress of the PIDTC to date, highlights of the first two PIDTC workshops, and consideration of future consortium objectives. PMID:24139498

  8. Nef from primary isolates of human immunodeficiency virus type 1 suppresses surface CD4 expression in human and mouse T cells.

    PubMed Central

    Anderson, S; Shugars, D C; Swanstrom, R; Garcia, J V

    1993-01-01

    The human immunodeficiency virus type 1 (HIV-1) nef gene was originally described as a negative regulator of transcription from the viral long terminal repeat promoter. This observation has been disputed, and the function of Nef remains unclear. In vivo experiments have indicated that an intact nef gene is required for disease progression in macaques infected with simian immunodeficiency virus, suggesting a role for Nef in the pathogenesis of AIDS. We and others have previously shown that expression of Nef in cells bearing surface CD4 results in a sustained decrease in surface CD4 expression. This was demonstrated for Nef from two laboratory strains of HIV-1, Bru and SF2. Because both of these isolates were passaged in vitro prior to molecular cloning and in vitro passage can result in mutations which might alter nef gene function, we have analyzed two primary isolates of Nef for their ability to suppress cell surface CD4 expression. The nef genes of HIV-1 isolates from two patients with fewer than 200 CD4+ T cells per mm3 of blood were introduced into human and mouse T-cell lines by retrovirus-mediated gene transfer. Expression of Nef from both isolates correlated with a decrease in surface expression of both human and mouse CD4. To determine whether the ability to suppress surface CD4 expression is a general function of Nef, we also tested an artificially generated consensus nef gene derived from analysis of 54 patient isolates of HIV-1. Expression of the consensus Nef protein also correlated with decreased cell surface CD4 expression in both mouse and human T-cell lines. These results suggest that the ability to suppress cell surface CD4 expression is an intrinsic feature of HIV-1 Nef. Images PMID:8331733

  9. Human plasma enhances the infectivity of primary human immunodeficiency virus type 1 isolates in peripheral blood mononuclear cells and monocyte-derived macrophages.

    PubMed Central

    Wu, S C; Spouge, J L; Conley, S R; Tsai, W P; Merges, M J; Nara, P L

    1995-01-01

    Physiological microenvironments such as blood, seminal plasma, mucosal secretions, or lymphatic fluids may influence the biology of the virus-host cell and immune interactions for human immunodeficiency virus type 1 (HIV-1). Relative to media, physiological levels of human plasma were found to enhance the infectivity of HIV-1 primary isolates in both phytohemagglutinin-stimulated peripheral blood mononuclear cells and monocyte-derived macrophages. Enhancement was observed only when plasma was present during the virus-cell incubation and resulted in a 3- to 30-fold increase in virus titers in all of the four primary isolates tested. Both infectivity and virion binding experiments demonstrated a slow, time-dependent process generally requiring between 1 and 10 h. Human plasma collected in anticoagulants CPDA-1 and heparin, but not EDTA, exhibited this effect at concentrations from 90 to 40%. Furthermore, heat-inactivated plasma resulted in a loss of enhancement in peripheral blood mononuclear cells but not in monocyte-derived macrophages. Physiological concentrations of human plasma appear to recruit additional infectivity, thus increasing the infectious potential of the virus inoculum. PMID:7666510

  10. Resistance of primary isolates of human immunodeficiency virus type 1 to soluble CD4 is independent of CD4-rgp120 binding affinity.

    PubMed Central

    Ashkenazi, A; Smith, D H; Marsters, S A; Riddle, L; Gregory, T J; Ho, D D; Capon, D J

    1991-01-01

    The infection of human cells by laboratory strains of human immunodeficiency virus type 1 (HIV-1) can be blocked readily in vitro by recombinant soluble CD4 and CD4-immunoglobulin hybrid molecules. In contrast, infection by primary isolates of HIV-1 is much less sensitive to blocking in vitro by soluble CD4-based molecules. To investigate the molecular basis for this difference between HIV-1 strains, we isolated the gp120-encoding genes from several CD4-resistant and CD4-sensitive HIV-1 strains and characterized the CD4-binding properties of their recombinant gp120 (rgp120) products. Extensive amino acid sequence variation was found between the gp120 genes of CD4-resistant and CD4-sensitive HIV-1 isolates. However, the CD4-binding affinities of rgp120 from strains with markedly different CD4 sensitivities were essentially the same, and only small differences were observed in the kinetics of CD4 binding. These results suggest that the lower sensitivity of primary HIV-1 isolates to neutralization by CD4-based molecules is not due to lower binding affinity between soluble CD4 and free gp120. PMID:1871120

  11. Inhibition of clinical human immunodeficiency virus (HIV) type 1 isolates in primary CD4+ T lymphocytes by retroviral vectors expressing anti-HIV genes.

    PubMed Central

    Vandendriessche, T; Chuah, M K; Chiang, L; Chang, H K; Ensoli, B; Morgan, R A

    1995-01-01

    Gene therapy may be of benefit in human immunodeficiency virus type 1 (HIV-1)-infected individuals by virtue of its ability to inhibit virus replication and prevent viral gene expression. It is not known whether anti-HIV-1 gene therapy strategies based on antisense or transdominant HIV-1 mutant proteins can inhibit the replication and expression of clinical HIV-1 isolates in primary CD4+ T lymphocytes. We therefore transduced CD4+ T lymphocytes from uninfected individuals with retroviral vectors expressing either HIV-1-specific antisense-TAR or antisense-Tat/Rev RNA, transdominant HIV-1 Rev protein, and a combination of antisense-TAR and transdominant Rev. The engineered CD4+ T lymphocytes were then infected with four different clinical HIV-1 isolates. We found that replication of all HIV-1 isolates was inhibited by all the anti-HIV vectors tested. Greater inhibition of HIV-1 was observed with transdominant Rev than with antisense RNA. We hereby demonstrated effective protection by antisense RNA or transdominant mutant proteins against HIV-1 infection in primary CD4+ T lymphocytes using clinical HIV-1 isolates, and this represents an essential step toward clinical anti-HIV-1 gene therapy. PMID:7769662

  12. Cascade control of superheated steam temperature with neuro-PID controller.

    PubMed

    Zhang, Jianhua; Zhang, Fenfang; Ren, Mifeng; Hou, Guolian; Fang, Fang

    2012-11-01

    In this paper, an improved cascade control methodology for superheated processes is developed, in which the primary PID controller is implemented by neural networks trained by minimizing error entropy criterion. The entropy of the tracking error can be estimated recursively by utilizing receding horizon window technique. The measurable disturbances in superheated processes are input to the neuro-PID controller besides the sequences of tracking error in outer loop control system, hence, feedback control is combined with feedforward control in the proposed neuro-PID controller. The convergent condition of the neural networks is analyzed. The implementation procedures of the proposed cascade control approach are summarized. Compared with the neuro-PID controller using minimizing squared error criterion, the proposed neuro-PID controller using minimizing error entropy criterion may decrease fluctuations of the superheated steam temperature. A simulation example shows the advantages of the proposed method.

  13. Outcomes of hematopoietic stem cell transplantation in primary immunodeficiency: a report from the Australian and New Zealand Children's Haematology Oncology Group and the Australasian Bone Marrow Transplant Recipient Registry.

    PubMed

    Mitchell, Richard; Nivison-Smith, Ian; Anazodo, Antoinette; Tiedemann, Karin; Shaw, Peter; Teague, Lochie; Fraser, Chris; Carter, Tina; Tapp, Heather; Alvaro, Frank; O'Brien, Tracey A

    2013-03-01

    We performed a retrospective analysis on the outcomes of 135 hematopoietic stem cell transplantations (HSCTs) for primary immunodeficiency disorders in Australian and New Zealand Children's Haematology Oncology Group transplantation centers between 1992 and 2008. The most common indications for HSCT were severe combined immunodeficiency, Wiskott-Aldrich syndrome, and chronic granulomatous disease. Five-year overall survival (OS) was 72% for the entire cohort. Disease-specific 5-year OS was 70% for severe combined immunodeficiency, 81% for Wiskott-Aldrich syndrome, and 69% for chronic granulomatous disease. Transplantation-related mortality (TRM) was 10% at day +100. TRM and OS were equivalent in recipients of related and unrelated donor transplants. Source of stem cells had no impact on TRM or OS with outcomes following unrelated umbilical cord blood similar to unrelated bone marrow. The presence of interstitial pneumonitis, active cytomegalovirus infection, or veno-occlusive disease were all independent variables that significantly decreased OS. This large series supports the use of HSCT as curative therapy for a range of primary immunodeficiency disorders, demonstrating excellent survival after both related and unrelated donor transplantation.

  14. Usage of the coreceptors CCR-5, CCR-3, and CXCR-4 by primary and cell line-adapted human immunodeficiency virus type 2.

    PubMed Central

    Sol, N; Ferchal, F; Braun, J; Pleskoff, O; Tréboute, C; Ansart, I; Alizon, M

    1997-01-01

    The chemokine receptors CCR-5 and CXCR-4, and possibly CCR-3, are the principal human immunodeficiency virus type 1 (HIV-1) coreceptors, apparently interacting with HIV-1 envelope, in association with CD4. Cell lines coexpressing CD4 and these chemokine receptors were infected with a panel of seven primary HIV-2 isolates passaged in peripheral blood mononuclear cells (PBMC) and three laboratory HIV-2 strains passaged in T-cell lines. The CCR-5, CCR-3, and CXCR-4 coreceptors could all be used by HIV-2. The ability to use CXCR-4 represents a major difference between HIV-2 and the closely related simian immunodeficiency viruses. Most HIV-2 strains using CCR-5 could also use CCR-3, sometimes with similar efficiencies. As observed for HIV-1, the usage of CCR-5 or CCR-3 was observed principally for HIV-2 strains derived from asymptomatic individuals, while HIV-2 strains derived from AIDS patients used CXCR-4. However, there were several exceptions, and the patterns of coreceptor usage seemed more complex for HIV-2 than for HIV-1. The two T-tropic HIV-2 strains tested used CXCR-4 and not CCR-5, while T-tropic HIV-1 can generally use both. Moreover, among five primary HIV-2 strains all unable to use CXCR-4, three could replicate in CCR-5-negative PBMC, which has not been reported for HIV-1. These observations suggest that the CCR-5 coreceptor is less important for HIV-2 than for HIV-1 and indicate that HIV-2 can use other cell entry pathways and probably other coreceptors. One HIV-2 isolate replicating in normal or CCR-5-negative PBMC failed to infect CXCR-4+ cells or the U87MG-CD4 and sMAGI cell lines, which are permissive to infection by HIV-2 but not by HIV-1. This suggests the existence of several HIV-2-specific coreceptors, which are differentially expressed in cell lines and PBMC. PMID:9343175

  15. Update on gene therapy for immunodeficiencies.

    PubMed

    Kohn, Donald B

    2010-05-01

    Primary immune deficiencies (PID) are due to blood cell defects and can be treated with transplantation of normal hematopoietic stem cells (HSC) from another person (allogeneic). Gene therapy in which a patient's autologous HSC are genetically corrected represents an alternative treatment for patients with PID, which could avoid the immunologic risks of allogeneic HSCT and confer similar benefits. Recent clinical trials using gene therapy have led to immune restoration in patients with X-linked severe combined immune deficiency (XSCID), adenosine deaminase (ADA)-deficient SCID and chronic granulomatous disease (CGD). However, severe complications arose in several of the patients in whom the integrated retroviral vectors led to leukoproliferative disorders. New approaches using safer integrating vectors or direct correction of the defective gene underlying the PID are being developed and may lead to safer and effective gene therapy for PID.

  16. Altered distribution of natural killer cell subsets identified by CD56, CD27 and CD70 in primary and chronic human immunodeficiency virus-1 infection

    PubMed Central

    Titanji, Kehmia; Sammicheli, Stefano; De Milito, Angelo; Mantegani, Paola; Fortis, Claudio; Berg, Louise; Kärre, Klas; Travi, Giovanna; Tassandin, Chiara; Lopalco, Lucia; Rethi, Bence; Tambussi, Giuseppe; Chiodi, Francesca

    2008-01-01

    Human natural killer (NK) (CD3− CD56+) cells can be divided into two functionally distinct subsets, CD3− CD56dim and CD3− CD56bright. We analysed the distribution of NK cell subsets in primary and chronic human immunodeficiency virus-1 (HIV-1) infection, to determine if HIV infection stage may influence the subset distribution. In primary infection, contrary to chronic infection, the CD3− CD56dim subset was expanded compared to healthy controls. We also studied the effect of antiretroviral therapy administered early in infection and found that NK cell subset distribution was partially restored after 6 months of antiretroviral therapy in primary infection, but not normalized. Recently, NK cells have been divided into CD27− and CD27+ subsets with different migratory and functional capacity and CD27-mediated NK cell activation has been described in mice. We therefore investigated whether CD27 and/or CD70 (CD27 ligand) expression on NK cells, and thus the distribution of these novel NK subsets, was altered in HIV-1-infected patients. We found up-regulated expression of both CD27 and CD70 on NK cells of patients, resulting in higher proportions of CD27high and CD70high NK cells, and this phenomenon was more pronounced in chronic infection. Experiments conducted in vitro suggest that the high interleukin-7 levels found during HIV-1 infection may participate in up-regulation of CD70 on NK cell subsets. Imbalance of NK cell subsets and up-regulated expression of CD27 and CD70 initiated early in HIV-1 infection may indicate NK cell activation and intrinsic defects initiated by HIV-1 to disarm the innate immune response to the virus. PMID:17627773

  17. Convergence performance comparisons of PID, MRAC, and PID + MRAC hybrid controller

    NASA Astrophysics Data System (ADS)

    Zhang, Dan; Wei, Bin

    2016-06-01

    This study proposes a hybrid controller by combining a proportional-integral-derivative (PID) control and a model reference adaptive control (MRAC), which named as PID + MRAC controller. The convergence performances of the PID control, MRAC, and hybrid PID + MRAC are also compared. Through the simulation in Matlab, the results show that the convergence speed and performance of the MRAC and the PID + MRAC controller are better than those of the PID controller. In addition, the convergence performance of the hybrid control is better than that of the MRAC control.

  18. PID control of gas pipelines

    SciTech Connect

    Coltharp, B.; Bergmann, J.

    1996-09-01

    The use of low cost digital controllers for pipeline control is increasing as the reliability and cost improves. In pipeline applications, the proportional, integral, and derivative (PID) controller algorithm is often used. However, the unique problems associated with pipeline operation have caused manufacturers to modify the basic control algorithms. Features such as set point ramping, built in pressure control, freeze on input error, and high and low output limits help assure safe and predictable pipeline operation.

  19. Quantitative model of antibody- and soluble CD4-mediated neutralization of primary isolates and T-cell line-adapted strains of human immunodeficiency virus type 1.

    PubMed Central

    Klasse, P J; Moore, J P

    1996-01-01

    Primary isolates (PI) of human immunodeficiency virus type 1 (HIV-1) are considerably less sensitive than T-cell line-adapted strains to neutralization by soluble CD4 and by most cross-reactive monoclonal antibodies to the viral envelope (Env) glycoprotein, as well as by postinfection and postvaccination sera (J. P. Moore and D. D. Ho, AIDS 9 [suppl. A]:5117-5136, 1995). We developed a quantitative model to explain the neutralization resistance of PI. The factors incorporated into the model are the dissociation constants for the binding of the neutralizing agent to native Env oligomers, the number of outer Env molecules on the viral surface (which decreases by shedding), and the minimum number of Env molecules required for attachment and fusion. We conclude that modest differences in all these factors can, when combined, explain a relative neutralization resistance of PI versus T-cell line-adapted strains that sometimes amounts to several orders of magnitude. The hypothesis that neutralization of HIV is due to the reduction below a minimum number of the Env molecules on a virion available for attachment and fusion is at odds with single- and few-hit neutralization theories. Our analysis of these ideas favors the hypothesis that neutralization of HIV is instead a competitive blocking of interactions with cellular factors, including adsorption receptors. PMID:8648701

  20. The Natural History of Children with Severe Combined Immunodeficiency: Baseline Features of the First Fifty Patients of the Primary Immune Deficiency Treatment Consortium Prospective Study 6901

    PubMed Central

    Dvorak, Christopher C.; Cowan, Morton J.; Logan, Brent R.; Notarangelo, Luigi D.; Griffith, Linda M.; Puck, Jennifer M.; Kohn, Donald B.; Shearer, William T.; O'Reilly, Richard J.; Fleisher, Thomas A.; Pai, Sung-Yun; Hanson, I. Celine; Pulsipher, Michael A.; Fuleihan, Ramsay; Filipovich, Alexandra; Goldman, Frederick; Kapoor, Neena; Small, Trudy; Smith, Angela; Chan, Ka-Wah; Cuvelier, Geoff; Heimall, Jennifer; Knutsen, Alan; Loechelt, Brett; Moore, Theodore; Buckley, Rebecca H.

    2013-01-01

    The Primary Immune Deficiency Treatment Consortium (PIDTC) consists of 33 centers in North America. We hypothesized that the analysis of uniform data on patients with severe combined immunodeficiency (SCID) enrolled in a prospective protocol will identify variables that contribute to optimal outcomes following treatment. We report baseline clinical, immunologic, and genetic features of the first 50 patients enrolled, and the initial therapies administered, reflecting current practice in the diagnosis and treatment of both typical (n = 37) and atypical forms (n = 13) of SCID. From August 2010 to May 2012, patients with suspected SCID underwent evaluation and therapy per local center practices. Diagnostic information was reviewed by the PIDTC eligibility review panel, and hematopoietic cell transplantation (HCT) details were obtained from the Center for International Blood and Marrow Transplant Research. Most patients (92%) had mutations in a known SCID gene. Half of the patients were diagnosed by newborn screening or family history, were younger than those diagnosed by clinical signs (median 15 vs. 181 days; P = <0.0001), and went to HCT at a median of 67 days vs. 214 days of life (P = <0.0001). Most patients (92%) were treated with HCT within 1–2 months of diagnosis. Three patients were treated with gene therapy and 1 with enzyme replacement. The PIDTC plans to enroll over 250 such patients and analyze short and long-term outcomes for factors beneficial or deleterious to survival, clinical outcome, and T- and B-cell reconstitution, and which biomarkers are predictive of these outcomes. PMID:23818196

  1. Calculating the Dose of Subcutaneous Immunoglobulin for Primary Immunodeficiency Disease in Patients Switched From Intravenous to Subcutaneous Immunoglobulin Without the Use of a Dose-Adjustment Coefficient

    PubMed Central

    Fadeyi, Michael; Tran, Tin

    2013-01-01

    Primary immunodeficiency disease (PIDD) is an inherited disorder characterized by an inadequate immune system. The most common type of PIDD is antibody deficiency. Patients with this disorder lack the ability to make functional immunoglobulin G (IgG) and require lifelong IgG replacement therapy to prevent serious bacterial infections. The current standard therapy for PIDD is intravenous immunoglobulin (IVIG) infusions, but IVIG might not be appropriate for all patients. For this reason, subcutaneous immunoglobulin (SCIG) has emerged as an alternative to IVIG. A concern for physicians is the precise SCIG dose that should be prescribed, because there are pharmacokinetic differences between IVIG and SCIG. Manufacturers of SCIG 10% and 20% liquid (immune globulin subcutaneous [human]) recommend a dose-adjustment coefficient (DAC). Both strengths are currently approved by the FDA. This DAC is to be used when patients are switched from IVIG to SCIG. In this article, we propose another dosing method that uses a higher ratio of IVIG to SCIG and an incremental adjustment based on clinical status, body weight, and the presence of concurrent diseases. PMID:24391400

  2. Kinetics of human immunodeficiency virus type 1 (HIV-1) DNA and RNA synthesis during primary HIV-1 infection.

    PubMed Central

    Graziosi, C; Pantaleo, G; Butini, L; Demarest, J F; Saag, M S; Shaw, G M; Fauci, A S

    1993-01-01

    HIV-1 replication and viral burden in peripheral blood mononuclear cells (PBMC) have been reported to be high in primary infection but generally very low during the prolonged period of clinical latency. It is uncertain precisely when this transition occurs during the HIV-1 infection and what the relationship is between the changes in HIV-1 replication versus the clearance of infected cells in the overall control of viral replication. In the present study, the kinetics of viral burden (i.e., frequency of HIV-1-infected cells) and replication during primary and early-chronic infection were analyzed in PBMC of four acutely infected individuals. High frequencies of HIV-1-infected cells and high levels of virus replication were observed in PBMC after primary HIV-1 infection. Down-regulation of virus replication in PBMC was observed in all four patients coincident with the emergence of HIV-1-specific immune responses. Other parameters of virus replication, such as circulating plasma p24 antigen and plasma viremia showed similar kinetics. In contrast, a significant decline in viral burden in PBMC was observed in only one of four patients. These results indicate that the down-regulation in the levels of virus replication associated with the clinical transition from acute to chronic infection does not necessarily reflect a reduction in viral burden, thus suggesting the involvement of additional factors. Identification of these factors will be important in elucidating the host mechanisms involved in the early control of HIV-1 infection and disease. Images Fig. 1 Fig. 2 Fig. 3 PMID:8341646

  3. The human immunodeficiency virus-1 nef gene product: a positive factor for viral infection and replication in primary lymphocytes and macrophages

    PubMed Central

    1994-01-01

    Considerable controversy and uncertainty have surrounded the biological function of the Human Immunodeficiency Virus (HIV)-1 nef gene product. Initial studies suggested that this early, nonstructural viral protein functioned as a negative regulatory factor; thus, it was proposed to play a role in establishing or maintaining viral latency. In contrast, studies in Simian Immunodeficiency Virus (SIV)mac-infected rhesus monkeys have suggested that Nef is not a negative factor but rather plays a central role in promoting high-level viral replication and is required for viral pathogenesis in vivo. We sought to define a tissue culture system that would approximate the in vivo setting for virus infection in order to assess the role of HIV-1 Nef in viral replication. We show that infection of mitogen-activated peripheral blood mononuclear cells (PBMC) with Nef+ HIV results in enhanced replication as evidenced by earlier gag p24 expression when compared with infections performed with nef mutant viruses. Moreover, when unstimulated freshly isolated PBMC are infected with Nef+ and Nef- viruses and then subsequently activated with mitogen, the Nef-induced difference in viral replication kinetics is even more pronounced, with the Nef- viruses requiring much more time in culture for appreciable growth. A positive effect of Nef on viral replication was also observed in primary macrophages infected with a recombinant of YU-2, a patient- derived molecular clone with macrophage tropism. These positive effects of Nef on viral replication are dependent on the initial multiplicity of infection (MOI), in that infections of unstimulated PBMC at low MOI are most dependent upon intact nef for subsequent viral growth. We now provide evidence that the Nef+ HIV is more infectious than Nef- HIV from both a tissue culture infectious dose analysis, and a single-cell HIV infection assay. In the latter case, we demonstrate that infection with equivalent doses of HIV based on virion-associated gag p

  4. Antibodies Elicited by Multiple Envelope Glycoprotein Immunogens in Primates Neutralize Primary Human Immunodeficiency Viruses (HIV-1) Sensitized by CD4-Mimetic Compounds

    PubMed Central

    Madani, Navid; Princiotto, Amy M.; Easterhoff, David; Bradley, Todd; Luo, Kan; Williams, Wilton B.; Liao, Hua-Xin; Moody, M. Anthony; Phad, Ganesh E.; Vázquez Bernat, Néstor; Melillo, Bruno; Santra, Sampa; Smith, Amos B.; Karlsson Hedestam, Gunilla B.; Haynes, Barton

    2016-01-01

    ABSTRACT The human immunodeficiency virus (HIV-1) envelope glycoproteins (Env) mediate virus entry through a series of complex conformational changes triggered by binding to the receptors CD4 and CCR5/CXCR4. Broadly neutralizing antibodies that recognize conserved Env epitopes are thought to be an important component of a protective immune response. However, to date, HIV-1 Env immunogens that elicit broadly neutralizing antibodies have not been identified, creating hurdles for vaccine development. Small-molecule CD4-mimetic compounds engage the CD4-binding pocket on the gp120 exterior Env and induce Env conformations that are highly sensitive to neutralization by antibodies, including antibodies directed against the conserved Env region that interacts with CCR5/CXCR4. Here, we show that CD4-mimetic compounds sensitize primary HIV-1 to neutralization by antibodies that can be elicited in monkeys and humans within 6 months by several Env vaccine candidates, including gp120 monomers. Monoclonal antibodies directed against the gp120 V2 and V3 variable regions were isolated from the immunized monkeys and humans; these monoclonal antibodies neutralized a primary HIV-1 only when the virus was sensitized by a CD4-mimetic compound. Thus, in addition to their direct antiviral effect, CD4-mimetic compounds dramatically enhance the HIV-1-neutralizing activity of antibodies that can be elicited with currently available immunogens. Used as components of microbicides, the CD4-mimetic compounds might increase the protective efficacy of HIV-1 vaccines. IMPORTANCE Preventing HIV-1 transmission is a high priority for global health. Eliciting antibodies that can neutralize transmitted strains of HIV-1 is difficult, creating problems for the development of an effective vaccine. We found that small-molecule CD4-mimetic compounds sensitize HIV-1 to antibodies that can be elicited in vaccinated humans and monkeys. These results suggest an approach to prevent HIV-1 sexual transmission in

  5. Evaluation of Performance of the Gen-Probe Human Immunodeficiency Virus Type 1 Viral Load Assay Using Primary Subtype A, C, and D Isolates from Kenya

    PubMed Central

    Emery, Sandra; Bodrug, Sharon; Richardson, Barbra A.; Giachetti, Cristina; Bott, Martha A.; Panteleeff, Dana; Jagodzinski, Linda L.; Michael, Nelson L.; Nduati, Ruth; Bwayo, Job; Kreiss, Joan K.; Overbaugh, Julie

    2000-01-01

    Accurate and sensitive quantification of human immunodeficiency virus type 1 (HIV-1) RNA has been invaluable as a marker for disease prognosis and for clinical monitoring of HIV-1 disease. The first generation of commercially available HIV-1 RNA tests were optimized to detect the predominant HIV-1 subtype found in North America and Europe, subtype B. However, these tests are frequently suboptimal in detecting HIV-1 genetic forms or subtypes found in other parts of the world. The goal of the present study was to evaluate the performance of a new viral load assay with non-subtype B viruses. A transcription-mediated amplification method for detection and quantitation of diverse HIV-1 subtypes, called the Gen-Probe HIV-1 viral load assay, is under development. In this study we examined the performance of the Gen-Probe HIV-1 viral load assay relative to that of the commonly used commercial HIV-1 RNA assays using a panel of primary isolates from Kenya. For comparison, we included several subtype B cloned viruses, and we quantified each virus using an in-house quantitative-competitive reverse transcriptase PCR (QC-RT-PCR) method and gagp24 antigen capture. The Gen-Probe HIV-1 viral load assay and a version of the Roche AMPLICOR HIV-1 MONITOR test (version 1.5) that was designed to detect a broader range of subtypes were both sensitive for the quantification of Kenyan primary isolates, which represented subtype A, C, and D viruses. The Gen-Probe HIV-1 viral load assay was more sensitive for the majority of viruses than the Roche AMPLICOR HIV-1 MONITOR test version 1.0, the Bayer Quantiplex HIV RNA 3.0 assay, or a QC-RT-PCR method in use in our laboratory, suggesting that it provides a useful method for quantifying HIV-1 RNAs from diverse parts of the world, including Africa. PMID:10878065

  6. Immune Dysregulation, Polyendocrinopathy, Enteropathy, X-Linked Syndrome: A Paradigm of Immunodeficiency with Autoimmunity

    PubMed Central

    Barzaghi, Federica; Passerini, Laura; Bacchetta, Rosa

    2012-01-01

    Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare monogenic primary immunodeficiency (PID) due to mutations of FOXP3, a key transcription factor for naturally occurring (n) regulatory T (Treg) cells. The dysfunction of Treg cells is the main pathogenic event leading to the multi-organ autoimmunity that characterizes IPEX syndrome, a paradigm of genetically determined PID with autoimmunity. IPEX has a severe early onset and can become rapidly fatal within the first year of life regardless of the type and site of the mutation. The initial presenting symptoms are severe enteritis and/or type-1 diabetes mellitus, alone or in combination with eczema and elevated serum IgE. Other autoimmune symptoms, such as hypothyroidism, cytopenia, hepatitis, nephropathy, arthritis, and alopecia can develop in patients who survive the initial acute phase. The current therapeutic options for IPEX patients are limited. Supportive and replacement therapies combined with pharmacological immunosuppression are required to control symptoms at onset. However, these procedures can allow only a reduction of the clinical manifestations without a permanent control of the disease. The only known effective cure for IPEX syndrome is hematopoietic stem cell transplantation, but it is always limited by the availability of a suitable donor and the lack of specific guidelines for bone marrow transplant in the context of this disease. This review aims to summarize the clinical histories and genomic mutations of the IPEX patients described in the literature to date. We will focus on the clinical and immunological features that allow differential diagnosis of IPEX syndrome and distinguish it from other PID with autoimmunity. The efficacy of the current therapies will be reviewed, and possible innovative approaches, based on the latest highlights of the pathogenesis to treat this severe primary autoimmune disease of childhood, will be discussed. PMID:23060872

  7. Recent advances in transplantation for primary immune deficiency diseases: a comprehensive review.

    PubMed

    de la Morena, M Teresa; Nelson, Robert P

    2014-04-01

    Hematopoietic cell transplantation (HCT) is a curative therapeutic option for severe combined immunodeficiency (SCID), a group of diseases which otherwise carry life expectancies that are of limited duration and quality. Survival following HCT for SCID has improved from approximately 23 to 91 % over the last 40 years. Success with SCID prompted efforts to apply HCT to the therapeutic challenge of well over 20 molecularly defined primary immune deficiency diseases (PID). Such success is due to both early recognition of PIDs and advances in the field of transplantation. Such advances include high-resolution HLA DNA donor-recipient matching, expansion of donor sources, better tolerated conditioning, new antibiotics, and wider availability. International collaborative efforts have provided patients and caregivers information that permit better treatment decisions now, and direct clinicians and investigators to ensure progress in the future. Pioneers in screening for SCID have taken steps to correct the fundamental challenge to successful treatment, which is the rapid discovery and characterization of cases and offering the transplant option to an affected child early in life; blood spot testing for T and B cell receptor quantification is now available to a growing fraction of newborns. Organizations including the Primary Immune Deficiency Treatment Consortium in the USA, The European Society for Primary Immunodeficiency, the European Group for Blood and Marrow Transplantation, the Pediatric Blood and Marrow Transplant Consortium, the United States Immunodeficiency Network, the Immune Deficiency Foundation, and the Jeffrey Modell Foundation are contributing mightily to increase awareness and standardize optimal utilization to the benefit of patients. This review will update the allergist-immunologist concerning disease presentations, indications for transplantation, methodologies, conditioning regimens, and clinical outcomes for patients with PID for which timely HCT is

  8. Gene Therapy for the Treatment of Primary Immune Deficiencies.

    PubMed

    Kuo, Caroline Y; Kohn, Donald B

    2016-05-01

    The use of gene therapy in the treatment of primary immune deficiencies (PID) has advanced significantly in the last decade. Clinical trials for X-linked severe combined immunodeficiency, adenosine deaminase deficiency (ADA), chronic granulomatous disease, and Wiskott-Aldrich syndrome have demonstrated that gene transfer into hematopoietic stem cells and autologous transplant can result in clinical improvement and is curative for many patients. Unfortunately, early clinical trials were complicated by vector-related insertional mutagenic events for several diseases with the exception of ADA-deficiency SCID. These results prompted the current wave of clinical trials for primary immunodeficiency using alternative retro- or lenti-viral vector constructs that are self-inactivating, and they have shown clinical efficacy without leukemic events thus far. The field of gene therapy continues to progress, with improvements in viral vector profiles, stem cell culturing techniques, and site-specific genome editing platforms. The future of gene therapy is promising, and we are quickly moving towards a time when it will be a standard cellular therapy for many forms of PID.

  9. Efficacy, safety, tolerability and pharmacokinetics of a novel human immune globulin subcutaneous, 20%: a Phase 2/3 study in Europe in patients with primary immunodeficiencies

    PubMed Central

    Borte, M.; Kriván, G.; Derfalvi, B.; Maródi, L.; Harrer, T.; Jolles, S.; Bourgeois, C.; Engl, W.; Leibl, H.; McCoy, B.; Gelmont, D.

    2016-01-01

    Summary A highly concentrated (20%) immunoglobulin (Ig)G preparation for subcutaneous administration (IGSC 20%), would offer a new option for antibody replacement therapy in patients with primary immunodeficiency diseases (PIDD). The efficacy, safety, tolerability and pharmacokinetics of IGSC 20% were evaluated in a prospective trial in Europe in 49 patients with PIDD aged 2–67 years. Over a median of 358 days, patients received 2349 IGSC 20% infusions at monthly doses equivalent to those administered for previous intravenous or subcutaneous IgG treatment. The rate of validated acute bacterial infections (VASBIs) was significantly lower than 1 per year (0·022/patient‐year, P < 0·0001); the rate of all infections was 4·38/patient‐year. Median trough IgG concentrations were ≥ 8 g/l. There was no serious adverse event (AE) deemed related to IGSC 20% treatment; related non‐serious AEs occurred at a rate of 0·101 event/infusion. The incidence of local related AEs was 0·069 event/infusion (0·036 event/infusion, when excluding a 13‐year‐old patient who reported 79 of 162 total related local AEs). The incidence of related systemic AEs was 0·032 event/infusion. Most related AEs were mild, none were severe. For 64·6% of patients and in 94·8% of IGSC 20% infusions, no local related AE occurred. The median infusion duration was 0·95 (range = 0·3‐4·1) h using mainly one to two administration sites [median = 2 sites (range = 1–5)]. Almost all infusions (99·8%) were administered without interruption/stopping or rate reduction. These results demonstrate that IGSC 20% provides an effective and well‐tolerated therapy for patients previously on intravenous or subcutaneous treatment, without the need for dose adjustment. PMID:27613250

  10. The natural history of children with severe combined immunodeficiency: baseline features of the first fifty patients of the primary immune deficiency treatment consortium prospective study 6901.

    PubMed

    Dvorak, Christopher C; Cowan, Morton J; Logan, Brent R; Notarangelo, Luigi D; Griffith, Linda M; Puck, Jennifer M; Kohn, Donald B; Shearer, William T; O'Reilly, Richard J; Fleisher, Thomas A; Pai, Sung-Yun; Hanson, I Celine; Pulsipher, Michael A; Fuleihan, Ramsay; Filipovich, Alexandra; Goldman, Frederick; Kapoor, Neena; Small, Trudy; Smith, Angela; Chan, Ka-Wah; Cuvelier, Geoff; Heimall, Jennifer; Knutsen, Alan; Loechelt, Brett; Moore, Theodore; Buckley, Rebecca H

    2013-10-01

    The Primary Immune Deficiency Treatment Consortium (PIDTC) consists of 33 centers in North America. We hypothesized that the analysis of uniform data on patients with severe combined immunodeficiency (SCID) enrolled in a prospective protocol will identify variables that contribute to optimal outcomes following treatment. We report baseline clinical, immunologic, and genetic features of the first 50 patients enrolled, and the initial therapies administered, reflecting current practice in the diagnosis and treatment of both typical (n = 37) and atypical forms (n = 13) of SCID. From August 2010 to May 2012, patients with suspected SCID underwent evaluation and therapy per local center practices. Diagnostic information was reviewed by the PIDTC eligibility review panel, and hematopoietic cell transplantation (HCT) details were obtained from the Center for International Blood and Marrow Transplant Research. Most patients (92 %) had mutations in a known SCID gene. Half of the patients were diagnosed by newborn screening or family history, were younger than those diagnosed by clinical signs (median 15 vs. 181 days; P = <0.0001), and went to HCT at a median of 67 days vs. 214 days of life (P = <0.0001). Most patients (92 %) were treated with HCT within 1-2 months of diagnosis. Three patients were treated with gene therapy and 1 with enzyme replacement. The PIDTC plans to enroll over 250 such patients and analyze short and long-term outcomes for factors beneficial or deleterious to survival, clinical outcome, and T- and B-cell reconstitution, and which biomarkers are predictive of these outcomes.

  11. Subcutaneous immunoglobulin (16 or 20%) therapy in obese patients with primary immunodeficiency: a retrospective analysis of administration by infusion pump or subcutaneous rapid push.

    PubMed

    Shapiro, R

    2013-08-01

    A retrospective chart review was conducted at a single centre, capturing data on 173 primary immunodeficiency disease (PIDD) patients, including 40 obese patients, using subcutaneous administration of immunoglobulin (Ig) (SCIG) (16 or 20%) delivered by infusion pump or subcutaneous (s.c.) rapid push. Patients previously using Ig administered as intravenous (i.v.) infusions (IVIG) were converted to SCIG dosing on a 1:1 basis. In both obese and non-obese patients, mean serum Ig levels were higher during SCIG administration (steady state) compared with IVIG administration (trough values). Similar SCIG dose : serum IgG level relationships were observed between obese and non-obese patients, suggesting the consistent bioavailability of SCIG regardless of body mass index (BMI). The mean SCIG volume per dosing site and the mean number of dosing days per week were greater with s.c. rapid push compared with infusion pump in this cohort, but the mean number of sites per infusion session was lower with s.c. rapid push. Both methods were well tolerated. The use of 20 versus 16% SCIG in obese patients improved dosing efficiency, resulting in smaller weekly volumes (54·7 versus 74·5 ml/week) and dosing on fewer days per week (2·3 versus 3·4 days). These data do not suggest a need for SCIG dosing adjustments in obese individuals relative to non-obese patients. The administration of SCIG using either infusion pump or s.c. rapid push is a practical and well-tolerated alternative to IVIG in obese patients. Offering various administration techniques provides a greater opportunity for treatment satisfaction and patient empowerment, which may support high levels of patient compliance.

  12. Detection of Candida dubliniensis in Oropharyngeal Samples from Human Immunodeficiency Virus-Infected Patients in North America by Primary CHROMagar Candida Screening and Susceptibility Testing of Isolates

    PubMed Central

    Kirkpatrick, William R.; Revankar, Sanjay G.; Mcatee, Robert K.; Lopez-Ribot, Jose L.; Fothergill, Annette W.; McCarthy, Dora I.; Sanche, Stephen E.; Cantu, Rebecca A.; Rinaldi, Michael G.; Patterson, Thomas F.

    1998-01-01

    Candida dubliniensis has been associated with oropharyngeal candidiasis in patients infected with human immunodeficiency virus (HIV). C. dubliniensis isolates may have been improperly characterized as atypical Candida albicans due to the phenotypic similarity between the two species. Prospective screening of oral rinses from 63 HIV-infected patients detected atypical dark green isolates on CHROMagar Candida compared to typical C. albicans isolates, which are light green. Forty-eight atypical isolates and three control strains were characterized by germ tube formation, differential growth at 37, 42, and 45°C, identification by API 20C, fluorescence, chlamydoconidium production, and fingerprinting by Ca3 probe DNA hybridization patterns. All isolates were germ tube positive. Very poor or no growth occurred at 42°C with 22 of 51 isolates. All 22 poorly growing isolates at 42°C and one isolate with growth at 42°C showed weak hybridization of the Ca3 probe with genomic DNA, consistent with C. dubliniensis identification. No C. dubliniensis isolate but only 18 of 28 C. albicans isolates grew at 45°C. Other phenotypic or morphologic tests were less reliable in differentiating C. dubliniensis from C. albicans. Antifungal susceptibility testing showed fluconazole MICs ranging from ≤0.125 to 64 μg/ml. Two isolates were resistant to fluconazole (MIC, 64 μg/ml) and one strain was dose dependent susceptible (MIC, 16 μg/ml). MICs of other azoles, including voriconazole, itraconazole, and SCH 56592, for these isolates were lower. C. dubliniensis was identified in 11 of 63 (17%) serially evaluated patients. Variability in phenotypic characteristics dictates the use of molecular and biochemical techniques to identify C. dubliniensis. This study identifies C. dubliniensis in HIV-infected patients from San Antonio, Tex., and shows that C. dubliniensis is frequently detected in those patients by using a primary CHROMagar screen. PMID:9738058

  13. Identification of gene products suppressed by human immunodeficiency virus type 1 infection or gp120 exposure of primary human astrocytes by rapid subtraction hybridization.

    PubMed

    Su, Zao-Zhong; Kang, Dong-Chul; Chen, Yinming; Pekarskaya, Olga; Chao, Wei; Volsky, David J; Fisher, Paul B

    2003-06-01

    Neurodegeneration and human immunodeficiency virus type 1 (HIV-1)-associated dementia (HAD) are the major disease manifestations of HIV-1 colonization of the central nervous system (CNS). In the brain, HIV-1 replicates in microglial cells and infiltrating macrophages and it persists in a low-productive, noncytolytic state in astrocytes. Astrocytes play critical roles in the maintenance of the brain microenvironment, responses to injury, and in neuronal signal transmission, and disruption of these functions by HIV-1 could contribute to HAD. To better understand the potential effects of HIV-1 on astrocyte biology, the authors investigated changes in gene expression using an efficient and sensitive rapid subtraction hybridization approach, RaSH. Primary human astrocytes were isolated from abortus brain tissue, low-passage cells were infected with HIV-1 or mock infected, and total cellular RNAs were isolated at multiple time points over a period of 1 week. This approach is designed to identify gene products modulated early and late after HIV-1 infection and limits the cloning of genes displaying normal cell-cycle fluctuations in astrocytes. By subtracting temporal cDNAs derived from HIV-1-infected astrocytes from temporal cDNAs made from uninfected cells, 10 genes displaying reduced expression in infected cells, termed astrocyte suppressed genes (ASGs), were identified and their suppression was confirmed by Northern blot hybridization. Both known and novel ASGs, not reported in current DNA databases, that are down-regulated by HIV-1 infection are described. Northern blotting confirms suppression of the same panel of ASGs by treatment of astrocytes with recombinant HIV-1 envelope glycoprotein, gp120. These results extend our previous analysis of astrocyte genes induced or enhanced by HIV-1 infection and together they suggest that HIV-1 and viral proteins have profound effects on astrocyte physiology, which may influence their function in the CNS.

  14. Efficacy, safety, tolerability and pharmacokinetics of a novel human immune globulin subcutaneous, 20%: a Phase 2/3 study in Europe in patients with primary immunodeficiencies.

    PubMed

    Borte, M; Kriván, G; Derfalvi, B; Maródi, L; Harrer, T; Jolles, S; Bourgeois, C; Engl, W; Leibl, H; McCoy, B; Gelmont, D; Yel, L

    2017-01-01

    A highly concentrated (20%) immunoglobulin (Ig)G preparation for subcutaneous administration (IGSC 20%), would offer a new option for antibody replacement therapy in patients with primary immunodeficiency diseases (PIDD). The efficacy, safety, tolerability and pharmacokinetics of IGSC 20% were evaluated in a prospective trial in Europe in 49 patients with PIDD aged 2-67 years. Over a median of 358 days, patients received 2349 IGSC 20% infusions at monthly doses equivalent to those administered for previous intravenous or subcutaneous IgG treatment. The rate of validated acute bacterial infections (VASBIs) was significantly lower than 1 per year (0·022/patient-year, P < 0·0001); the rate of all infections was 4·38/patient-year. Median trough IgG concentrations were ≥ 8 g/l. There was no serious adverse event (AE) deemed related to IGSC 20% treatment; related non-serious AEs occurred at a rate of 0·101 event/infusion. The incidence of local related AEs was 0·069 event/infusion (0·036 event/infusion, when excluding a 13-year-old patient who reported 79 of 162 total related local AEs). The incidence of related systemic AEs was 0·032 event/infusion. Most related AEs were mild, none were severe. For 64·6% of patients and in 94·8% of IGSC 20% infusions, no local related AE occurred. The median infusion duration was 0·95 (range = 0·3-4·1) h using mainly one to two administration sites [median = 2 sites (range = 1-5)]. Almost all infusions (99·8%) were administered without interruption/stopping or rate reduction. These results demonstrate that IGSC 20% provides an effective and well-tolerated therapy for patients previously on intravenous or subcutaneous treatment, without the need for dose adjustment.

  15. New tuning method for PID controller.

    PubMed

    Shen, Jing-Chung

    2002-10-01

    In this paper, a tuning method for proportional-integral-derivative (PID) controller and the performance assessment formulas for this method are proposed. This tuning method is based on a genetic algorithm based PID controller design method. For deriving the tuning formula, the genetic algorithm based design method is applied to design PID controllers for a variety of processes. The relationship between the controller parameters and the parameters that characterize the process dynamics are determined and the tuning formula is then derived. Using simulation studies, the rules for assessing the performance of a PID controller tuned by the proposed method are also given. This makes it possible to incorporate the capability to determine if the PID controller is well tuned or not into an autotuner. An autotuner based on this new tuning method and the corresponding performance assessment rules is also established. Simulations and real-time experimental results are given to demonstrate the effectiveness and usefulness of these formulas.

  16. Severe combined immunodeficiency (SCID): from molecular basis to clinical management.

    PubMed

    Sponzilli, Ivonne; Notarangelo, Luigi D

    2011-04-01

    Primary immune deficiency diseases (PID) comprise a genetically heterogeneous group of disorders that affect distinct components of the innate and adaptive immune system, such as neutrophils, macrophages, dendritic cells, complement proteins, natural killer cells, as well as T and B lymphocytes. Severe combined immunodeficiency (SCID) is a group of disorders characterized by increased susceptibility to severe infections and early death. The diagnosis of SCID is supported by the demonstration of low absolute lymphocyte count and T cell lymphopenia (variably associated with numerical defects of B and NK cells). In the last two decades, advances in the characterization of the molecular pathophysiology of SCID, have permitted the development of novel diagnostic assays based on analysis of the expression of the disease-associated proteins and mutation analysis. More recently, pilot newborn screening programs for the identification of infants with SCID have been initiated in the United States. Prompt and aggressive treatment of infections, antimicrobial prophylaxis (in particular against Pneumocystis jiroveci) and regular administration of immunoglobulins are essential to reduce the risk of early death. However, survival ultimately depends on reconstitution of immune function, that is usually achieved by means of hematopoietic cell transplantation (HCT). Gene therapy and enzyme replacement therapy have also been used successfully is selected forms of SCID. Here we review the molecular and cellular pathophysiology and the mainstay of treatment of SCID.

  17. Neurodevelopmental Impairment among Infants Born to Mothers Infected with Human Immunodeficiency Virus and Uninfected Mothers from Three Peri-Urban Primary Care Clinics in Harare, Zimbabwe

    ERIC Educational Resources Information Center

    Kandawasvika, Gwendoline Q.; Ogundipe, Enitan; Gumbo, Felicity Z.; Kurewa, Edith N.; Mapingure, Munyaradzi P.; Stray-Pedersen, Babill

    2011-01-01

    Aim: The aim of this article is to document the risk of neurodevelopmental impairment (NDI) among infants enrolled in a programme for the prevention of mother-to-child transmission of HIV (human immunodeficiency virus) in Zimbabwe using the Bayley Infant Neurodevelopmental Screener (BINS). Method: We prospectively followed up infants at three…

  18. Assessment of intracellular cytokines and regulatory cells in patients with autoimmune diseases and primary immunodeficiencies - novel tool for diagnostics and patient follow-up.

    PubMed

    Osnes, Liv T; Nakken, Britt; Bodolay, Edit; Szodoray, Peter

    2013-08-01

    Serum and intracytoplasmic cytokines are mandatory in host defense against microbes, but also play a pivotal role in the pathogenesis of autoimmune diseases by initiating and perpetuating various cellular and humoral autoimmune processes. The intricate interplay and fine balance of pro- and anti-inflammatory processes drive, whether inflammation and eventually organ damage will occur, or the inflammatory cascade quenches. In the early and late, as well as inactive and active stages of autoimmune diseases, different cellular and molecular patterns can dominate in these patients. However, the simultaneous assessment of pro- and anti-inflammatory biomarkers aids to define the immunological state of a patient. A group of the most useful inflammatory biomarkers are cytokines, and with increasing knowledge during the last decade their role have been well-defined in patients with autoimmune diseases and immunodeficiencies. Multiple pathological processes drive the development of autoimmunity and immunodeficiencies, most of which involve quantitative and qualitative disturbances in regulatory cells, cytokine synthesis and signaling pathways. The assessment of these biomarkers does not aid only in the mechanistic description of autoimmune diseases and immunodeficiencies, but further helps to subcategorize diseases and to evaluate therapy responses. Here, we provide an overview, how monitoring of cytokines and regulatory cells aid in the diagnosis and follow-up of patients with autoimmune diseases and immunodeficiencies furthermore, we pinpoint novel cellular and molecular diagnostic possibilities in these diseases.

  19. British Lung Foundation/United Kingdom Primary Immunodeficiency Network Consensus Statement on the Definition, Diagnosis, and Management of Granulomatous-Lymphocytic Interstitial Lung Disease in Common Variable Immunodeficiency Disorders.

    PubMed

    Hurst, John R; Verma, Nisha; Lowe, David; Baxendale, Helen E; Jolles, Stephen; Kelleher, Peter; Longhurst, Hilary J; Patel, Smita Y; Renzoni, Elisabetta A; Sander, Clare R; Avery, Gerard R; Babar, Judith L; Buckland, Matthew S; Burns, Siobhan; Egner, William; Gompels, Mark M; Gordins, Pavels; Haddock, Jamanda A; Hart, Simon P; Hayman, Grant R; Herriot, Richard; Hoyles, Rachel K; Huissoon, Aarnoud P; Jacob, Joseph; Nicholson, Andrew G; Rassl, Doris M; Sargur, Ravishankar B; Savic, Sinisa; Seneviratne, Suranjith L; Sheaff, Michael; Vaitla, Prashantha M; Walters, Gareth I; Whitehouse, Joanna L; Wright, Penny A; Condliffe, Alison M

    2017-03-25

    A proportion of people living with common variable immunodeficiency disorders develop granulomatous-lymphocytic interstitial lung disease (GLILD). We aimed to develop a consensus statement on the definition, diagnosis, and management of GLILD. All UK specialist centers were contacted and relevant physicians were invited to take part in a 3-round online Delphi process. Responses were graded as Strongly Agree, Tend to Agree, Neither Agree nor Disagree, Tend to Disagree, and Strongly Disagree, scored +1, +0.5, 0, -0.5, and -1, respectively. Agreement was defined as greater than or equal to 80% consensus. Scores are reported as mean ± SD. There was 100% agreement (score, 0.92 ± 0.19) for the following definition: "GLILD is a distinct clinico-radio-pathological ILD occurring in patients with [common variable immunodeficiency disorders], associated with a lymphocytic infiltrate and/or granuloma in the lung, and in whom other conditions have been considered and where possible excluded." There was consensus that the workup of suspected GLILD requires chest computed tomography (CT) (0.98 ± 0.01), lung function tests (eg, gas transfer, 0.94 ± 0.17), bronchoscopy to exclude infection (0.63 ± 0.50), and lung biopsy (0.58 ± 0.40). There was no consensus on whether expectant management following optimization of immunoglobulin therapy was acceptable: 67% agreed, 25% disagreed, score 0.38 ± 0.59; 90% agreed that when treatment was required, first-line treatment should be with corticosteroids alone (score, 0.55 ± 0.51).

  20. Multivariable PID Controller For Robotic Manipulator

    NASA Technical Reports Server (NTRS)

    Seraji, Homayoun; Tarokh, Mahmoud

    1990-01-01

    Gains updated during operation to cope with changes in characteristics and loads. Conceptual multivariable controller for robotic manipulator includes proportional/derivative (PD) controller in inner feedback loop, and proportional/integral/derivative (PID) controller in outer feedback loop. PD controller places poles of transfer function (in Laplace-transform space) of control system for linearized mathematical model of dynamics of robot. PID controller tracks trajectory and decouples input and output.

  1. Insertion of primary syncytium-inducing (SI) and non-SI envelope V3 loops in human immunodeficiency virus type 1 (HIV-1) LAI reduces neutralization sensitivity to autologous, but not heterologous, HIV-1 antibodies.

    PubMed Central

    Hogervorst, E; de Jong, J; van Wijk, A; Bakker, M; Valk, M; Nara, P; Goudsmit, J

    1995-01-01

    The aim of the study was to investigate the influence of V3 loops from naturally occurring viruses on the neutralization sensitivity of a molecularly cloned virus. A selection of well-defined syncytium-inducing (SI) and non-SI V3 loops of a single human immunodeficiency virus type 1-infected individual (H594) and the V3 regions of two SI laboratory strains were inserted in an infectious molecular clone of human immunodeficiency type 1 LAI. Neutralization was performed with a heterologous serum pool and autologous patient serum, using the virus reduction neutralization assay and peripheral blood lymphocytes as target cells. High sensitivity of the chimeric viruses containing the laboratory strain V3 regions to neutralization by H594 sequential sera as well as the heterologous serum pool was found. A statistically significant correlation between the sensitivities of these viruses was seen. In contrast, insertion of the primary isolate NSI and SI envelope V3 loops significantly reduced the neutralization by autologous serum but not by the heterologous serum pool. No correlation was found between the neutralization of the viruses with laboratory strain-derived V3 regions and the viruses with primary isolate V3 domains. We conclude that heterologous antibodies are able to neutralize infectious molecular clones with V3 loops of both SI and NSI viruses, regardless of whether they originated from laboratory strains or primary isolates. However, serum of patient H594 discriminated between the two types of viruses and showed reduced neutralization of the viruses with the autologous NSI and SI primary isolate V3 loops. These results indicated that the neutralization sensitivity of the viruses depended on the capacity of the V3 region to influence the conformation of the virus envelope. These V3-dependent conformational changes partially explain the neutralization sensitivity of laboratory strains and the relative neutralization resistance of primary isolates. PMID:7666535

  2. [Classification and diagnosis of immunodeficiency syndromes].

    PubMed

    Warnatz, K; Peter, H-H

    2004-08-01

    Primary immunodeficiency diseases of the adult are rare disorders, but often lead to serious consequences. Therefore an early diagnosis is critical. The variety in the clinical presentation, the complexity of the immune system and the ongoing discovery of new defects render it a difficult area for the involved physician. Due to the often imprecise complaint of a weak immune system the primary task is the identification of patients with true immunodeficiency. Subsequently, the immune defect needs to be identified in collaboration with a center for immunodeficiency disorders. The diagnostic procedure is dependent on the pattern of infections and follows a defined series of steps. This procedure should prevent costly diagnostic evaluation when not indicated, and also prevent the delayed diagnosis of patients with manifest immunodeficiency disease.

  3. Common Variable Immunodeficiency.

    PubMed

    Saikia, Biman; Gupta, Sudhir

    2016-04-01

    Common variable immunodeficiency (CVID) is the most common primary immunodeficiency of young adolescents and adults which also affects the children. The disease remains largely under-diagnosed in India and Southeast Asian countries. Although in majority of cases it is sporadic, disease may be inherited in a autosomal recessive pattern and rarely, in autosomal dominant pattern. Patients, in addition to frequent sino-pulmonary infections, are also susceptible to various autoimmune diseases and malignancy, predominantly lymphoma and leukemia. Other characteristic lesions include lymphocytic and granulomatous interstitial lung disease, and nodular lymphoid hyperplasia of gut. Diagnosis requires reduced levels of at least two immunoglobulin isotypes: IgG with IgA and/or IgM and impaired specific antibody response to vaccines. A number of gene mutations have been described in CVID; however, these genetic alterations account for less than 20% of cases of CVID. Flow cytometry aptly demonstrates a disturbed B cell homeostasis with reduced or absent memory B cells and increased CD21(low) B cells and transitional B cell populations. Approximately one-third of patients with CVID also display T cell functional defects. Immunoglobulin therapy remains the mainstay of treatment. Immunologists and other clinicians in India and other South East Asian countries need to be aware of CVID so that early diagnosis can be made, as currently, majority of these patients still go undiagnosed.

  4. Genetic defects in common variable immunodeficiency

    PubMed Central

    Kopecký, O; Lukešová, Š

    2007-01-01

    Common variable immunodeficiency (CVID) is the most frequent clinically manifested primary immunodeficiency. According to clinical and laboratory findings, CVID is a heterogeneous group of diseases. Recently, the defects of molecules regulating activation and terminal differentiation of B lymphocytes have been described in some patients with CVID. In this study, we show the overview of deficiencies of inducible costimulator, transmembrane activator and calcium-modulator and cytophilin ligand interactor, CD19 molecules, their genetic basis, pathogenesis and clinical manifestations. PMID:17627754

  5. [Cancer as secondary immunodeficiency. Review].

    PubMed

    Vargas-Camaño, María Eugenia; Guido-Bayardo, Ricardo Leopoldo; Martínez-Aguilar, Nora Ernestina; Castrejón-Vázquez, María Isabel

    2016-01-01

    Secondary immunodeficiencys, previously presented in immunocompetent individuals. The lack of primary or secondary response to the presence of a foreign antigen, in the case of infections is a sentinel data in the diagnosis of immunodeficiency (can be primary or secondary), in the case of a self antigen may generate the presence of Cancer. Cancer has shown an increase in the prevalence and incidence globally. Most current medical treatments in cancer are focused primarily on immunomodulatory actions (immunosuppression / immune stimulation or both). Knowledge of key concepts from the perspective of innate and acquired immunity lead to cancer development, engaging immune surveillance and escape mechanisms of this that contribute to better understand the origin, behavior and treatment of neoplasm's. These treatments can cause immunological disorders such as allergy, anaphylaxis, lack of response immunogenicity care fields specialist in allergy and clinical immunology.

  6. Quantum Efficiency Loss after PID Stress: Wavelength Dependence on Cell Surface and Cell Edge

    SciTech Connect

    Oh, Jaewon; Bowden, Stuart; TamizhMani, GovindaSamy; Hacke, Peter

    2015-06-14

    It is known that the potential induced degradation (PID) stress of conventional p-base solar cells affects power, shunt resistance, junction recombination, and quantum efficiency (QE). One of the primary solutions to address the PID issue is a modification of chemical and physical properties of antireflection coating (ARC) on the cell surface. Depending on the edge isolation method used during cell processing, the ARC layer near the edges may be uniformly or non-uniformly damaged. Therefore, the pathway for sodium migration from glass to the cell junction could be either through all of the ARC surface if surface and edge ARC have low quality or through the cell edge if surface ARC has high quality but edge ARC is defective due to certain edge isolation process. In this study, two PID susceptible cells from two different manufacturers have been investigated. The QE measurements of these cells before and after PID stress were performed at both surface and edge. We observed the wavelength dependent QE loss only in the first manufacturer's cell but not in the second manufacturer's cell. The first manufacturer's cell appeared to have low quality ARC whereas the second manufacturer's cell appeared to have high quality ARC with defective edge. To rapidly screen a large number of cells for PID stress testing, a new but simple test setup that does not require laminated cell coupon has been developed and is used in this investigation.

  7. Extracellular human immunodeficiency virus type 1 Tat protein is associated with an increase in both NF-kappa B binding and protein kinase C activity in primary human astrocytes.

    PubMed Central

    Conant, K; Ma, M; Nath, A; Major, E O

    1996-01-01

    Human immunodeficiency virus type 1 (HIV-1) infection has been associated with an increase in the binding of the transcription factor NF-kappa B to its consensus sequence in the viral promoter. Using cultures of primary human fetal astrocytes, we show that exogenous HIV-1 Tat protein, which has been demonstrated to be released from infected cells, is associated with an increase in the binding of this transcription factor to an HIV-1 long terminal repeat kappa B sequence. This effect occurs rapidly and is independent of new protein synthesis. We also demonstrate that extracellular Tat protein is associated with an increase in protein kinase C activity. If Tat functions similarly in other cell types, such findings could relate to some of this protein's previously described physiological effects. These effects include Tat's ability to upregulate the synthesis of specific cytokines and to act as a growth factor. PMID:8627654

  8. Use and interpretation of diagnostic vaccination in primary immunodeficiency: a working group report of the Basic and Clinical Immunology Interest Section of the American Academy of Allergy, Asthma & Immunology.

    PubMed

    Orange, Jordan S; Ballow, Mark; Stiehm, E Richard; Ballas, Zuhair K; Chinen, Javier; De La Morena, Maite; Kumararatne, Dinakantha; Harville, Terry O; Hesterberg, Paul; Koleilat, Majed; McGhee, Sean; Perez, Elena E; Raasch, Jason; Scherzer, Rebecca; Schroeder, Harry; Seroogy, Christine; Huissoon, Aarnoud; Sorensen, Ricardo U; Katial, Rohit

    2012-09-01

    A major diagnostic intervention in the consideration of many patients suspected to have primary immunodeficiency diseases (PIDDs) is the application and interpretation of vaccination. Specifically, the antibody response to antigenic challenge with vaccines can provide substantive insight into the status of human immune function. There are numerous vaccines that are commonly used in healthy individuals, as well as others that are available for specialized applications. Both can potentially be used to facilitate consideration of PIDD. However, the application of vaccines and interpretation of antibody responses in this context are complex. These rely on consideration of numerous existing specific studies, interpolation of data from healthy populations, current diagnostic guidelines, and expert subspecialist practice. This document represents an attempt of a working group of the American Academy of Allergy, Asthma & Immunology to provide further guidance and synthesis in this use of vaccination for diagnostic purposes in consideration of PIDD, as well as to identify key areas for further research.

  9. Rates of ectopic pregnancy, sterility follow PID rise.

    PubMed

    1980-05-01

    500,000 cases of PID (pelvic inflammatory disease) are reported annually in the US, with 34,000 to 92,000 women becoming sterile as a consequence of the disease. In addition, the contraceptive methods women use during their exposure to PID-causing agents may directly affect their relative risk of developing PID, at an annual cost of $2.7 billion in health-care expenses. Another sequelae of PID is ectopic pregnancy. The STD epidemic years from 1965 to 1975 are projected to increase the rate of ectopic pregnancies to 50,000 a year, or one for every 60 live births before leveling off. By 1990, 1 out of 32 women will have had an ectopic pregnancy. Tubal occlusion can result in involuntary infertility. The National Survey of Family Growth estimates that the prevalence of infertile women aged 15 to 44 who are married and use no contraceptive method has increased in the past 2-1/2 years from 2.7% to 6.1%. These women number 142,000 annually and resort to nonsurgical sterilization, with PID as a major reason. Gonococcal PID accounts for 34,000 to 92,000 women becoming involuntarily sterile each year. However, over 80% of PID is nongonococcal PID, which is a worst disease. Chronic PID and infertility are found "more often in women who have had nongonococcal PID than in women who have had gonococcal PID." Etiologic organisms of PID include gonorrhea; E. coli, anaerobes and Chlamydia trachomatis.

  10. Virions of primary human immunodeficiency virus type 1 isolates resistant to soluble CD4 (sCD4) neutralization differ in sCD4 binding and glycoprotein gp120 retention from sCD4-sensitive isolates.

    PubMed Central

    Moore, J P; McKeating, J A; Huang, Y X; Ashkenazi, A; Ho, D D

    1992-01-01

    Primary isolates of human immunodeficiency virus type 1 (HIV-1) are much less sensitive to neutralization by soluble CD4 (sCD4) and sCD4-immunoglobulin (Ig) chimeras (CD4-IgG) than are HIV-1 strains adapted to growth in cell culture. We demonstrated that there are significant reductions (10- to 30-fold) in the binding of sCD4 and CD4-IgG to intact virions of five primary isolates compared with sCD4-sensitive, cell culture-adapted isolates RF and IIIB. However, soluble envelope glycoproteins (gp120) derived from the primary isolate virions, directly by detergent solubilization or indirectly by recombinant DNA technology, differed in affinity from RF and IIIB gp120 by only one- to threefold. The reduced binding of sCD4 to these primary isolate virions must therefore be a consequence of the tertiary or quaternary structure of the envelope glycoproteins in their native, oligomeric form on the viral surface. In addition, the rate and extent of sCD4-induced gp120 shedding from these primary isolates was lower than that from RF. We suggest that reduced sCD4 binding and increased gp120 retention together account for the relative resistance of these primary isolates to neutralization by sCD4 and CD4-IgG and that virions of different HIV-1 isolates vary both in the mechanism of sCD4 binding and in subsequent conformational changes in their envelope glycoproteins. PMID:1727487

  11. Study finds OC users protected against onset of chlamydial PID.

    PubMed

    1987-09-01

    Preliminary results from a large case-controlled study on the relationship between oral contraceptives and chlamydial infections refute the suspicion that pills increase the chance of contracting chlamydia, and clearly show that pills inhibit progression of an existing infection into chlamydial pelvic inflammatory disease (PID). The research was conducted in Seattle at Washington University. Subjects recruited from a sexually transmitted disease clinic included 700 patients, 100 with clinically verified PID, classified into those with chlamydia, gonorrhea, neither, and PID or no PID. Compared to 762 controls, oral contraceptive users had 1/8 the risk of chlamydial PID; compared to women using no contraception, their risk was 1/11. Oral contraception was safer than other methods with respect to chlamydial PID. No such pattern was evident when gonorrhea incidence was examined. It should be emphasized that pills do not protect against other types of PID. Nor do they prevent the start of a chlamydia infection.

  12. Infection of macrophages and dendritic cells with primary R5-tropic human immunodeficiency virus type 1 inhibited by natural polyreactive anti-CCR5 antibodies purified from cervicovaginal secretions.

    PubMed

    Eslahpazir, Jobin; Jenabian, Mohammad-Ali; Bouhlal, Hicham; Hocini, Hakim; Carbonneil, Cédric; Grésenguet, Gérard; Mbopi Kéou, François-Xavier; LeGoff, Jérôme; Saïdi, Héla; Requena, Mary; Nasreddine, Nadine; de Dieu Longo, Jean; Kaveri, Srinivas V; Bélec, Laurent

    2008-05-01

    Heterosexual contact is the primary mode of human immunodeficiency virus (HIV) type 1 (HIV-1) transmission worldwide. The chemokine receptor CCR5 is the major coreceptor that is associated with the mucosal transmission of R5-tropic HIV-1 during sexual intercourse. The CCR5 molecule is thus a target for antibody-based therapeutic strategies aimed at blocking HIV-1 entry into cells. We have previously demonstrated that polyreactive natural antibodies (NAbs) from therapeutic preparations of immunoglobulin G and from human breast milk contain NAbs directed against CCR5. Such antibodies inhibit the infection of human macrophages and T lymphocytes by R5-tropic isolates of HIV in vitro. In the present study, we demonstrate that human immunoglobulins from the cervicovaginal secretions of HIV-seronegative or HIV-seropositive women contain NAbs directed against the HIV-1 coreceptor CCR5. Natural affinity-purified anti-CCR5 antibodies bound to CCR5 expressed on macrophages and dendritic cells and further inhibited the infection of macrophages and dendritic cells with primary and laboratory-adapted R5-tropic HIV but not with X4-tropic HIV. Natural anti-CCR5 antibodies moderately inhibited R5-tropic HIV transfer from monocyte-derived dendritic cells to autologous T cells. Our results suggest that mucosal anti-CCR5 antibodies from healthy immunocompetent donors may hamper the penetration of HIV and may be suitable for use in the development of novel passive immunotherapy regimens in specific clinical settings of HIV infection.

  13. Infection of Macrophages and Dendritic Cells with Primary R5-Tropic Human Immunodeficiency Virus Type 1 Inhibited by Natural Polyreactive Anti-CCR5 Antibodies Purified from Cervicovaginal Secretions▿

    PubMed Central

    Eslahpazir, Jobin; Jenabian, Mohammad-Ali; Bouhlal, Hicham; Hocini, Hakim; Carbonneil, Cédric; Grésenguet, Gérard; Kéou, François-Xavier Mbopi; LeGoff, Jérôme; Saïdi, Héla; Requena, Mary; Nasreddine, Nadine; de Dieu Longo, Jean; Kaveri, Srinivas V.; Bélec, Laurent

    2008-01-01

    Heterosexual contact is the primary mode of human immunodeficiency virus (HIV) type 1 (HIV-1) transmission worldwide. The chemokine receptor CCR5 is the major coreceptor that is associated with the mucosal transmission of R5-tropic HIV-1 during sexual intercourse. The CCR5 molecule is thus a target for antibody-based therapeutic strategies aimed at blocking HIV-1 entry into cells. We have previously demonstrated that polyreactive natural antibodies (NAbs) from therapeutic preparations of immunoglobulin G and from human breast milk contain NAbs directed against CCR5. Such antibodies inhibit the infection of human macrophages and T lymphocytes by R5-tropic isolates of HIV in vitro. In the present study, we demonstrate that human immunoglobulins from the cervicovaginal secretions of HIV-seronegative or HIV-seropositive women contain NAbs directed against the HIV-1 coreceptor CCR5. Natural affinity-purified anti-CCR5 antibodies bound to CCR5 expressed on macrophages and dendritic cells and further inhibited the infection of macrophages and dendritic cells with primary and laboratory-adapted R5-tropic HIV but not with X4-tropic HIV. Natural anti-CCR5 antibodies moderately inhibited R5-tropic HIV transfer from monocyte-derived dendritic cells to autologous T cells. Our results suggest that mucosal anti-CCR5 antibodies from healthy immunocompetent donors may hamper the penetration of HIV and may be suitable for use in the development of novel passive immunotherapy regimens in specific clinical settings of HIV infection. PMID:18353923

  14. Human Immunodeficiency Virus Type 1 Neutralization Measured by Flow Cytometric Quantitation of Single-Round Infection of Primary Human T Cells

    PubMed Central

    Mascola, John R.; Louder, Mark K.; Winter, Christine; Prabhakara, Ranjani; De Rosa, Stephen C.; Douek, Daniel C.; Hill, Brenna J.; Gabuzda, Dana; Roederer, Mario

    2002-01-01

    There is currently intensive research on the design of novel human immunodeficiency virus type 1 (HIV-1) vaccine immunogens that can elicit potent neutralizing antibodies. A prerequisite for comparing and optimizing these strategies is the ability to precisely measure neutralizing antibody responses. To this end, we sought to develop an assay that directly quantifies single-round HIV-1 infection of peripheral blood mononuclear cells (PBMC). Initial experiments demonstrated that essentially all productively infected PBMC could be identified by flow cytometric detection of intracellular p24 antigen (p24-Ag). After infection of PBMC with HIV-1, p24+ lymphocytes could be distinguished beginning 1 day postinfection, and the majority of CD8− T cells were p24-Ag positive by 3 to 4 days postinfection. To directly quantify first-round infection, we included a protease inhibitor in PBMC cultures. The resulting 2-day assay was highly sensitive and specific for the detection of HIV-1-infected PBMC. Serial dilutions of virus stocks demonstrated that the number of target cells infected was directly related to the amount of infectious virus input into the assay. In neutralization assays, the flow cytometric enumeration of first-round infection of PBMC provided quantitative data on the number of target cells infected and on the inactivation of infectious virus due to reaction with antibody. We also used this single-round assay to compare the percentage of cells expressing p24-Ag to the number of copies of HIV-1 gag per 100 PBMC. The precision and reproducibility of this assay will facilitate the measurement of HIV-1 neutralization, particularly incrementally improved neutralizing antibody responses generated by new candidate vaccines. PMID:11967298

  15. PID Control Effectiveness for Surface Reactor Concepts

    SciTech Connect

    Dixon, David D.; Marsh, Christopher L.; Poston, David I.

    2007-01-30

    Control of space and surface fission reactors should be kept as simple as possible, because of the need for high reliability and the difficulty to diagnose and adapt to control system failures. Fortunately, compact, fast-spectrum, externally controlled reactors are very simple in operation. In fact, for some applications it may be possible to design low-power surface reactors without the need for any reactor control after startup; however, a simple proportional, integral, derivative (PID) controller can allow a higher performance concept and add more flexibility to system operation. This paper investigates the effectiveness of a PID control scheme for several anticipated transients that a surface reactor might experience. To perform these analyses, the surface reactor transient code FRINK was modified to simulate control drum movements based on bulk coolant temperature.

  16. Variable-order fuzzy fractional PID controller.

    PubMed

    Liu, Lu; Pan, Feng; Xue, Dingyu

    2015-03-01

    In this paper, a new tuning method of variable-order fractional fuzzy PID controller (VOFFLC) is proposed for a class of fractional-order and integer-order control plants. Fuzzy logic control (FLC) could easily deal with parameter variations of control system, but the fractional-order parameters are unable to change through this way and it has confined the effectiveness of FLC. Therefore, an attempt is made in this paper to allow all the five parameters of fractional-order PID controller vary along with the transformation of system structure as the outputs of FLC, and the influence of fractional orders λ and μ on control systems has been investigated to make the fuzzy rules for VOFFLC. Four simulation results of different plants are shown to verify the availability of the proposed control strategy.

  17. Genetics Home Reference: X-linked severe combined immunodeficiency

    MedlinePlus

    ... Chinen J, Puck JM. Successes and risks of gene therapy in primary immunodeficiencies. J Allergy Clin Immunol. 2004 ... Review. Citation on PubMed Puck JM, Malech HL. Gene therapy for immune disorders: good news tempered by bad ...

  18. Variable Constraints on the Principal Immunodominant Domain of the Transmembrane Glycoprotein of Human Immunodeficiency Virus Type 1

    PubMed Central

    Merat, Rastine; Raoul, Herve; Leste-Lasserre, Thierry; Sonigo, Pierre; Pancino, Gianfranco

    1999-01-01

    Lentiviruses have in their transmembrane glycoprotein (TM) a highly immunogenic structure referred to as the principal immunodominant domain (PID). The PID forms a loop of 5 to 7 amino acids between two conserved cysteines. Previous studies showed that envelope (Env) glycoprotein functions of feline immunodeficiency virus (FIV) could be retained after extensive mutation of the PID loop sequence, in spite of its high conservation. In order to compare Env function in different lentiviruses, either random mutations were introduced in the PID loop sequence of human immunodeficiency virus type 1 (HIV-1) or the entire HIV-1 PID loop was replaced by the corresponding PID loop of FIV or simian immunodeficiency virus (SIV). In the macrophage-tropic HIV-1 ADA Env, mutations impaired the processing of the gp160 Env precursor, thereby abolishing viral infectivity. However, 6 of the 108 random Env mutants that were screened retained the capacity to induce cell membrane fusion. The SIV and FIV sequences and five random mutations were then introduced in the context of T-cell-line-adapted HIV-1 LAI which, although phenotypically distant from HIV-1 ADA, has an identical PID loop sequence. In contrast to the situation for HIV-1 ADA mutants, the cleavage of the Env precursor was unaffected in most HIV-1 LAI mutants. Such mutations, however, resulted in increased shedding of the gp120 surface glycoprotein (SU) from the gp41 TM. The HIV-1 LAI Env mutants showed high fusogenic efficiency. Three Env mutants retained the capacity to mediate virus entry in target cells, although less efficiently than the wild-type Env, and allowed the reconstitution of infectious molecular clones. These results indicated that in HIV-1, like FIV, the conserved PID sequence can be changed without impairing Env function. However, functional constraints on the PID of HIV-1 vary depending on the structural context of Env, presumably in relation to the role of the PID in the interaction of the SU and TM subunits

  19. An adaptive pattern based nonlinear PID controller.

    PubMed

    Segovia, Juan Pablo; Sbarbaro, Daniel; Ceballos, Eric

    2004-04-01

    This paper presents a nonlinear proportional-integral-derivative (PID) controller, combining a pattern based adaptive algorithm to cope with the problem of tuning the controller, and an associative memory to store the parameters, according to different operating conditions. The simplicity of the algorithm enables its implementation in current programmable logic controller technology. Several real-time experiments, carried out in a pressurized tank, illustrate the performance of the proposed controller.

  20. Toll-like receptor signaling in primary immune deficiencies

    PubMed Central

    Maglione, Paul J.; Simchoni, Noa; Cunningham-Rundles, Charlotte

    2015-01-01

    Toll-like receptors (TLRs) recognize common microbial or host-derived macromolecules and have important roles in early activation of the immune system. Patients with primary immune deficiencies (PIDs) affecting TLR signaling can elucidate the importance of these proteins to the human immune system. Defects in interleukin-1 receptor-associated kinase (IRAK)-4 and myeloid differentiation factor 88 (MyD88) lead to susceptibility to infections with bacteria, while mutations in nuclear factor-κB essential modulator (NEMO) and other downstream mediators generally induce broader susceptibility to bacteria, viruses, and fungi. In contrast, TLR3 signaling defects are specific for susceptibility to herpes simplex virus type 1 (HSV-1) encephalitis. Other PIDs induce functional alterations of TLR signaling pathways, such as common variable immunodeficiency in which plasmacytoid dendritic cell (pDC) defects enhance defective responses of B cells to shared TLR agonists. Dampening of TLR responses is seen for TLRs 2 and 4 in chronic granulomatous disease (CGD) and X-linked agammaglobulinemia (XLA). Enhanced TLR responses, meanwhile, are seen for TLRs 5 and 9 in CGD, TLRs 4, 7/8, and 9 in XLA, TLRs 2 and 4 in hyper IgE syndrome, and for most TLRs in adenosine deaminase deficiency. PMID:25930993

  1. Use of aspirin and statins for the primary prevention of myocardial infarction and stroke in patients with human immunodeficiency virus infection.

    PubMed

    Park, Tae Eun; Yusuff, Jameela; Sharma, Roopali

    2016-05-01

    This retrospective, cross-sectional study evaluated whether HIV-infected patients received aspirin and statins for the primary prevention of myocardial infarction and stroke. Among the 258 patients included, 50.4% (n = 130/258) of the patients had a high risk of myocardial infarction and 14% (n = 36/258) of stroke. Overall, 43.1% (n = 56/130) and 50% (n = 18/36) of the patients were prescribed aspirin for the primary prevention of myocardial infarction and stroke, respectively. Among the patients who required statin therapy, 42.5% (n = 34/80) and 37.1% (n = 13/35) of patients received it for the primary prevention of myocardial infarction and stroke, respectively. The patients who had hypertension (odds ratio 3.8, 95% confidence interval 1.5-10.9) and diabetes mellitus (odds ratio 5.6, 95% confidence interval 2.6-12.4) were more likely to receive aspirin. Interventions are needed to improve provider awareness of the use of aspirin and statins in the primary prevention of myocardial infarction and stroke in HIV-infected patients.

  2. Soft Real-Time PID Control on a VME Computer

    NASA Technical Reports Server (NTRS)

    Karayan, Vahag; Sander, Stanley; Cageao, Richard

    2007-01-01

    microPID (uPID) is a computer program for real-time proportional + integral + derivative (PID) control of a translation stage in a Fourier-transform ultraviolet spectrometer. microPID implements a PID control loop over a position profile at sampling rate of 8 kHz (sampling period 125microseconds). The software runs in a strippeddown Linux operating system on a VersaModule Eurocard (VME) computer operating in real-time priority queue using an embedded controller, a 16-bit digital-to-analog converter (D/A) board, and a laser-positioning board (LPB). microPID consists of three main parts: (1) VME device-driver routines, (2) software that administers a custom protocol for serial communication with a control computer, and (3) a loop section that obtains the current position from an LPB-driver routine, calculates the ideal position from the profile, and calculates a new voltage command by use of an embedded PID routine all within each sampling period. The voltage command is sent to the D/A board to control the stage. microPID uses special kernel headers to obtain microsecond timing resolution. Inasmuch as microPID implements a single-threaded process and all other processes are disabled, the Linux operating system acts as a soft real-time system.

  3. Differential role of long terminal repeat control elements for the regulation of basal and Tat-mediated transcription of the human immunodeficiency virus in stimulated and unstimulated primary human macrophages.

    PubMed

    Moses, A V; Ibanez, C; Gaynor, R; Ghazal, P; Nelson, J A

    1994-01-01

    Primary human macrophages induced to differentiate through contact with autologous activated nonadherent cells were used to investigate the transcriptional mechanisms involved in reactivation of human immunodeficiency virus (HIV) replication. Through transient transfection experiments with an HIV long terminal repeat (LTR)-chloramphenicol acetyltransferase reporter construct, we show that macrophage differentiation results in a 20-fold upregulation of basal LTR activity. To identify sequence elements responsive to the differentiation process, point mutations introduced into the LTR were tested in differentiated and undifferentiated macrophages. Several elements were identified as positive regulators of basal transcription. TATA, Sp1, and NF-kappa B binding sites were the most influential. The low-affinity site for LBP-1 (UBP-1) functioned as a negative regulator of LTR activity in undifferentiated macrophages, but this influence was lost upon differentiation. When tat was cotransfected into the expression system, the requirement for LTR elements identified as important for positive regulation of basal transcription remained in undifferentiated macrophages. Interestingly, however, the mutations in positive control elements which debilitated activity in undifferentiated macrophages had no effect on LTR activity in differentiated macrophages. Thus, it appears that while HIV-LTR activity is highly dependent on cellular transcription factors in undifferentiated cells, in differentiated macrophages the viral protein Tat confers pliability on the LTR and facilitates autonomy from absolute cellular control mechanisms. In vivo, release from either positive or negative regulation via cellular proteins may facilitate reactivation of HIV in macrophages.

  4. Autoimmunity in Common Variable Immunodeficiency

    PubMed Central

    Agarwal, Shradha; Cunningham-Rundles, Charlotte

    2010-01-01

    Common variable immunodeficiency (CVID) is the most common clinically significant primary immune defect. Although the hallmark of CVID is hypogammaglobulinemia, the intrinsic dysregulation of the immune system leads to defective T-cell activation and proliferation, as well as dendritic cell and cytokine defects. Although 70% to 80% of patients have had recurrent sinopulmonary infections, auto-immunity and inflammatory complications are also common. The most common autoimmune conditions are immune thrombocytopenic purpura and hemolytic anemia, but other autoimmune complications arise, including rheumatoid arthritis, pernicious anemia, primary biliary cirrhosis, thyroiditis, sicca syndrome, systemic lupus, and inflammatory bowel disease. Treatment of autoimmunity includes high-dose immunoglobulins, corticosteroids, selected immunosuppressants, and other immune modulators. This review focuses on autoimmune conditions associated with CVID, potential mechanisms of immune dysregulation, and therapeutic strategies. PMID:19671377

  5. Potent and synergistic neutralization of human immunodeficiency virus (HIV) type 1 primary isolates by hyperimmune anti-HIV immunoglobulin combined with monoclonal antibodies 2F5 and 2G12.

    PubMed

    Mascola, J R; Louder, M K; VanCott, T C; Sapan, C V; Lambert, J S; Muenz, L R; Bunow, B; Birx, D L; Robb, M L

    1997-10-01

    Three antibody reagents that neutralize primary human immunodeficiency virus type 1 (HIV-1) isolates were tested for magnitude and breadth of neutralization when used alone or in double or triple combinations. Hyperimmune anti-HIV immunoglobulin (HIVIG) is derived from the plasma of HIV-1-infected donors, and monoclonal antibodies (MAbs) 2F5 and 2G12 bind to distinct regions of the HIV-1 envelope glycoprotein. The antibodies were initially tested against a panel of 15 clade B HIV-1 isolates, using a single concentration that is achievable in vivo (HIVIG, 2,500 microg/ml; MAbs, 25 microg/ml). Individual antibody reagents neutralized many of the viruses tested, but antibody potency varied substantially among the viruses. The virus neutralization produced by double combinations of HIVIG plus 2F5 or 2G12, the two MAbs together, or the triple combination of HIVIG, 2F5, and 2G12 was generally equal to or greater than that predicted by the effect of individual antibodies. Overall, the triple combination displayed the greatest magnitude and breadth of neutralization. Synergistic neutralization was evaluated by analyzing data from dose-response curves of each individual antibody reagent compared to the triple combination and was demonstrated against each of four viruses tested. Therefore, combinations of polyclonal and monoclonal anti-HIV antibodies can produce additive or synergistic neutralization of primary HIV-1 isolates. Passive immunotherapy for treatment or prophylaxis of HIV-1 should consider mixtures of potent neutralizing antibody reagents to expand the magnitude and breadth of virus neutralization.

  6. Potent and synergistic neutralization of human immunodeficiency virus (HIV) type 1 primary isolates by hyperimmune anti-HIV immunoglobulin combined with monoclonal antibodies 2F5 and 2G12.

    PubMed Central

    Mascola, J R; Louder, M K; VanCott, T C; Sapan, C V; Lambert, J S; Muenz, L R; Bunow, B; Birx, D L; Robb, M L

    1997-01-01

    Three antibody reagents that neutralize primary human immunodeficiency virus type 1 (HIV-1) isolates were tested for magnitude and breadth of neutralization when used alone or in double or triple combinations. Hyperimmune anti-HIV immunoglobulin (HIVIG) is derived from the plasma of HIV-1-infected donors, and monoclonal antibodies (MAbs) 2F5 and 2G12 bind to distinct regions of the HIV-1 envelope glycoprotein. The antibodies were initially tested against a panel of 15 clade B HIV-1 isolates, using a single concentration that is achievable in vivo (HIVIG, 2,500 microg/ml; MAbs, 25 microg/ml). Individual antibody reagents neutralized many of the viruses tested, but antibody potency varied substantially among the viruses. The virus neutralization produced by double combinations of HIVIG plus 2F5 or 2G12, the two MAbs together, or the triple combination of HIVIG, 2F5, and 2G12 was generally equal to or greater than that predicted by the effect of individual antibodies. Overall, the triple combination displayed the greatest magnitude and breadth of neutralization. Synergistic neutralization was evaluated by analyzing data from dose-response curves of each individual antibody reagent compared to the triple combination and was demonstrated against each of four viruses tested. Therefore, combinations of polyclonal and monoclonal anti-HIV antibodies can produce additive or synergistic neutralization of primary HIV-1 isolates. Passive immunotherapy for treatment or prophylaxis of HIV-1 should consider mixtures of potent neutralizing antibody reagents to expand the magnitude and breadth of virus neutralization. PMID:9311792

  7. Severe combined immunodeficiency in Serbia and Montenegro between years 1986 and 2010: a single-center experience.

    PubMed

    Pasic, Srdjan; Vujic, Dragana; Veljković, Dobrila; Slavkovic, Bojana; Mostarica-Stojkovic, Marija; Minic, Predrag; Minic, Aleksandra; Ristic, Goran; Giliani, Silvia; Villa, Anna; Sobacchi, Cristina; Lilić, Desa; Abinun, Mario

    2014-04-01

    Severe combined immunodeficiency (SCID), including the 'variant' Omenn syndrome (OS), represent a heterogeneous group of monogenic disorders characterized by defect in differentiation of T- and/or B lymphocytes and susceptibility to infections since birth. In the period of 25 years, between January 1986 and December 2010, a total of 21 patients (15 SCID, 6 OS) were diagnosed in Mother & Child Health Institute of Serbia, a tertiary-care teaching University hospital and a national referral center for patients affected with primary immunodeficiency (PID). The diagnoses were based on anamnestic data, clinical findings, and immunological and genetic analysis. The median age at the onset of the first infection was the 2nd month of life. Seven (33 %) patients had positive family history for SCID. Out of five male infants with T-B+NK- SCID phenotype, mutation analysis revealed interleukin-2 (common) gamma-chain receptor (IL2RG) mutations in 3 with positive X-linked family history, and Janus-kinase (JAK)-3 gene defects in the other two. Six patients had T-B-NK+ SCID phenotype and further 6 features of OS, 11 of which had recombinase-activating gene (RAG1or RAG2) and 1 Artemis gene mutations. One child with T+B+NK+ SCID phenotype as well had proven RAG mutation. One child each with T-B+NK+ SCID phenotype, CD8 lymphopenia and unknown phenotype remained without known underlying genetic defect. Of the eight patients who underwent hematopoetic stem cell transplant (HSCT) 5 survived, the other 13 died between 2 days and 12 months after diagnosis was made. Early diagnosis of SCID, before onset of severe infections, offers possibility for HSCT and cure. Education of primary-care pediatricians, in particular including awareness of the risk of using live vaccines and non-irradiated blood products, should improve prognosis of SCID in our setting.

  8. Exploiting Fractional Order PID Controller Methods in Improving the Performance of Integer Order PID Controllers: A GA Based Approach

    NASA Astrophysics Data System (ADS)

    Mukherjee, Bijoy K.; Metia, Santanu

    2009-10-01

    The paper is divided into three parts. The first part gives a brief introduction to the overall paper, to fractional order PID (PIλDμ) controllers and to Genetic Algorithm (GA). In the second part, first it has been studied how the performance of an integer order PID controller deteriorates when implemented with lossy capacitors in its analog realization. Thereafter it has been shown that the lossy capacitors can be effectively modeled by fractional order terms. Then, a novel GA based method has been proposed to tune the controller parameters such that the original performance is retained even though realized with the same lossy capacitors. Simulation results have been presented to validate the usefulness of the method. Some Ziegler-Nichols type tuning rules for design of fractional order PID controllers have been proposed in the literature [11]. In the third part, a novel GA based method has been proposed which shows how equivalent integer order PID controllers can be obtained which will give performance level similar to those of the fractional order PID controllers thereby removing the complexity involved in the implementation of the latter. It has been shown with extensive simulation results that the equivalent integer order PID controllers more or less retain the robustness and iso-damping properties of the original fractional order PID controllers. Simulation results also show that the equivalent integer order PID controllers are more robust than the normal Ziegler-Nichols tuned PID controllers.

  9. Identification of new splice sites used for generation of rev transcripts in human immunodeficiency virus type 1 subtype C primary isolates.

    PubMed

    Delgado, Elena; Carrera, Cristina; Nebreda, Paloma; Fernández-García, Aurora; Pinilla, Milagros; García, Valentina; Pérez-Álvarez, Lucía; Thomson, Michael M

    2012-01-01

    The HIV-1 primary transcript undergoes a complex splicing process by which more than 40 different spliced RNAs are generated. One of the factors contributing to HIV-1 splicing complexity is the multiplicity of 3' splice sites (3'ss) used for generation of rev RNAs, with two 3'ss, A4a and A4b, being most commonly used, a third site, A4c, used less frequently, and two additional sites, A4d and A4e, reported in only two and one isolates, respectively. HIV-1 splicing has been analyzed mostly in subtype B isolates, and data on other group M clades are lacking. Here we examine splice site usage in three primary isolates of subtype C, the most prevalent clade in the HIV-1 pandemic, by using an in vitro infection assay of peripheral blood mononuclear cells. Viral spliced RNAs were identified by RT-PCR amplification using a fluorescently-labeled primer and software analyses and by cloning and sequencing the amplified products. The results revealed that splice site usage for generation of rev transcripts in subtype C differs from that reported for subtype B, with most rev RNAs using two previously unreported 3'ss, one located 7 nucleotides upstream of 3'ss A4a, designated A4f, preferentially used by two isolates, and another located 14 nucleotides upstream of 3'ss A4c, designated A4g, preferentially used by the third isolate. A new 5' splice site, designated D2a, was also identified in one virus. Usage of the newly identified splice sites is consistent with sequence features commonly found in subtype C viruses. These results show that splice site usage may differ between HIV-1 subtypes.

  10. A tuning method of two degrees of freedom PID controller

    SciTech Connect

    Kasahara, Masato; Kimbara, Akiomi; Kurosu, Shigeru; Matsuba, Tadahiko; Kamimura, Kazuyuki; Murasawa, Itaru; Hashimoto, Yukihiro

    1997-12-31

    This paper proposes a new tuning method when using a two degrees of freedom proportional-integral-derivative (PID) controller. Its control performance for a first-order lag plus deadtime system is shown as an example of the commonly approximated controlled plants in the heating, ventilating, and air-conditioning (HVAC) field. Reference and disturbance input changes to a conventional PID controller do not necessarily give a satisfactory response. To overcome this problem, several two degrees of freedom PID (2 DOF PID) algorithms have been developed to replace the conventional PID controllers. However, when these techniques are applied to real plants, it is not usually easy to obtain a set of optimum tuning parameters. To evaluate the control performance, a comparison is carried out between the two tuning methods--the optimization technique and the partial model matching method--using simulation. Graphs by which the controller parameters can be related to dynamics of a popular plant are developed. The 2 DOF PID control is studied taking into account modeling error due to a change in plant characteristics. It is found that the 2 DOF PID controller designed based on the partial model matching method is robust and useful in simulations where a traditional PID controller would be used.

  11. Testing for Human Immunodeficiency Virus

    MedlinePlus

    ... incisions made in the mother’s abdomen and uterus. Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS). Immune System: ...

  12. A comparison of fuzzy logic-PID control strategies for PWR pressurizer control

    SciTech Connect

    Kavaklioglu, K.; Ikonomopoulos, A. )

    1993-01-01

    This paper describes the results obtained from a comparison performed between classical proportional-integral-derivative (PID) and fuzzy logic (FL) controlling the pressure in a pressurized water reactor (PWR). The two methodologies have been tested under various transient scenarios, and their performances are evaluated with respect to robustness and on-time response to external stimuli. One of the main concerns in the safe operation of PWR is the pressure control in the primary side of the system. In order to maintain the pressure in a PWR at the desired level, the pressurizer component equipped with sprayers, heaters, and safety relief valves is used. The control strategy in a Westinghouse PWR is implemented with a PID controller that initiates either the electric heaters or the sprayers, depending on the direction of the coolant pressure deviation from the setpoint.

  13. IMC-EB10, an anti-FLT3 monoclonal antibody, prolongs survival and reduces nonobese diabetic/severe combined immunodeficient engraftment of some acute lymphoblastic leukemia cell lines and primary leukemic samples.

    PubMed

    Piloto, Obdulio; Nguyen, Bao; Huso, David; Kim, Kyu-Tae; Li, Yiwen; Witte, Larry; Hicklin, Daniel J; Brown, Patrick; Small, Donald

    2006-05-01

    The class III receptor tyrosine kinase FLT3 is expressed on the blasts of >90% of patients with B-lineage acute lymphoblastic leukemias (ALL). In addition, it is expressed at extremely high levels in ALL patients with mixed lineage leukemia rearrangements or hyperdiploidy and is sometimes mutated in these same patients. In this report, we investigate the effects of treating ALL cell lines and primary samples with human anti-FLT3 monoclonal antibodies (mAb) capable of preventing binding of FLT3 ligand. In vitro studies, examining the ability of two anti-FLT3 mAbs (IMC-EB10 and IMC-NC7) to affect FLT3 activation and downstream signaling in ALL cell lines and primary blasts, yielded variable results. FLT3 phosphorylation was consistently inhibited by IMC-NC7 treatment, but in some cell lines, IMC-EB10 actually stimulated FLT3 activation, possibly as a result of antibody-mediated receptor dimerization. Through antibody-dependent, cell-mediated cytotoxicity, such an antibody could still prove efficacious against leukemia cells in vivo. In fact, IMC-EB10 treatment significantly prolonged survival and/or reduced engraftment of several ALL cell lines and primary ALL samples in nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice. This occurred even when IMC-EB10 treatment resulted in FLT3 activation in vitro. Moreover, fluorescence-activated cell sorting and PCR analysis of IMC-EB10-treated NOD/SCID mice surviving 150 days post-leukemic cell injection revealed that FLT3 immunotherapy reduced leukemic engraftment below the level of detection in these assays (<0.001%). Furthermore, in vivo IMC-EB10 treatment did not select for resistant cells, because cells surviving IMC-EB10 treatment remain sensitive to IMC-EB10 cytotoxicity upon retransplantation. In vivo studies involving either partial depletion or activation of natural killer (NK) cells show that most of the cytotoxic effect of IMC-EB10 is mediated through NK cells. Therefore, such an antibody, either

  14. Severe Combined Immunodeficiency Disorders.

    PubMed

    Chinn, Ivan K; Shearer, William T

    2015-11-01

    Severe combined immunodeficiency disorders represent pediatric emergencies due to absence of adaptive immune responses to infections. The conditions result from either intrinsic defects in T-cell development (ie, severe combined immunodeficiency disease [SCID]) or congenital athymia (eg, complete DiGeorge anomaly). Hematopoietic stem cell transplant provides the only clinically approved cure for SCID, although gene therapy research trials are showing significant promise. For greatest survival, patients should undergo transplant before 3.5 months of age and before the onset of infections. Newborn screening programs have yielded successful early identification and treatment of infants with SCID and congenital athymia in the United States.

  15. PID techniques: Alternatives to RICH Methods

    SciTech Connect

    Vavra, J.; /SLAC

    2011-03-01

    In this review article we discuss the recent progress in PID techniques other than the RICH methods. In particular we mention the recent progress in the Transition Radiation Detector (TRD), dE/dx cluster counting, and Time Of Flight (TOF) techniques. The TRD technique is mature and has been tried in many hadron colliders. It needs space though, about 20cm of detector radial space for every factor of 10 in the {pi}/e rejection power, and this tends to make such detectors large. Although the cluster counting technique is an old idea, it was never tried in a real physics experiment. Recently, there are efforts to revive it for the SuperB experiment using He-based gases and waveform digitizing electronics. A factor of almost 2 improvement, compared to the classical dE/dx performance, is possible in principle. However, the complexity of the data analysis will be substantial. The TOF technique is well established, but introduction of new fast MCP-PMT and G-APD detectors creates new possibilities. It seems that resolutions below 20-30ps may be possible at some point in the future with relatively small systems, and perhaps this could be pushed down to 10-15ps with very small systems, assuming that one can solve many systematic issues. However, the cost, rate limitation, aging and cross-talk in multi-anode devices at high BW are problems. There are several groups working on these issues, so progress is likely. Table 6 summarizes the author's opinion of pros and cons of various detectors presented in this paper based on their operational capabilities. We refer the reader to Ref.40 for discussion of other more general limits from the PID point of view.

  16. A new adaptive configuration of PID type fuzzy logic controller.

    PubMed

    Fereidouni, Alireza; Masoum, Mohammad A S; Moghbel, Moayed

    2015-05-01

    In this paper, an adaptive configuration for PID type fuzzy logic controller (FLC) is proposed to improve the performances of both conventional PID (C-PID) controller and conventional PID type FLC (C-PID-FLC). The proposed configuration is called adaptive because its output scaling factors (SFs) are dynamically tuned while the controller is functioning. The initial values of SFs are calculated based on its well-tuned counterpart while the proceeding values are generated using a proposed stochastic hybrid bacterial foraging particle swarm optimization (h-BF-PSO) algorithm. The performance of the proposed configuration is evaluated through extensive simulations for different operating conditions (changes in reference, load disturbance and noise signals). The results reveal that the proposed scheme performs significantly better over the C-PID controller and the C-PID-FLC in terms of several performance indices (integral absolute error (IAE), integral-of-time-multiplied absolute error (ITAE) and integral-of-time-multiplied squared error (ITSE)), overshoot and settling time for plants with and without dead time.

  17. Analysis of direct action fuzzy PID controller structures.

    PubMed

    Mann, G I; Hu, B G; Gosine, R G

    1999-01-01

    The majority of the research work on fuzzy PID controllers focuses on the conventional two-input PI or PD type controller proposed by Mamdani (1974). However, fuzzy PID controller design is still a complex task due to the involvement of a large number of parameters in defining the fuzzy rule base. This paper investigates different fuzzy PID controller structures, including the Mamdani-type controller. By expressing the fuzzy rules in different forms, each PLD structure is distinctly identified. For purpose of analysis, a linear-like fuzzy controller is defined. A simple analytical procedure is developed to deduce the closed form solution for a three-input fuzzy inference. This solution is used to identify the fuzzy PID action of each structure type in the dissociated form. The solution for single-input-single-output nonlinear fuzzy inferences illustrates the effect of nonlinearity tuning. The design of a fuzzy PID controller is then treated as a two-level tuning problem. The first level tunes the nonlinear PID gains and the second level tunes the linear gains, including scale factors of fuzzy variables. By assigning a minimum number of rules to each type, the linear and nonlinear gains are deduced and explicitly presented. The tuning characteristics of different fuzzy PID structures are evaluated with respect to their functional behaviors. The rule decoupled and one-input rule structures proposed in this paper provide greater flexibility and better functional properties than the conventional fuzzy PHD structures.

  18. Clinical characteristics and genetic profiles of 44 patients with severe combined immunodeficiency (SCID): report from Shanghai, China (2004-2011).

    PubMed

    Yao, Chun-Mei; Han, Xiao-Hua; Zhang, Yi-Dan; Zhang, Hui; Jin, Ying-Ying; Cao, Rui-Ming; Wang, Xi; Liu, Quan-Hua; Zhao, Wei; Chen, Tong-Xin

    2013-04-01

    Severe combined immunodeficiency (SCID), a rare type of genetic associated immune disorder, is poorly characterized in mainland China. We retrospectively reviewed 44 patients with SCID who received treatment from 2004 to 2011 in Shanghai, China, and herein summarize their clinical manifestations and immunological and preliminary genetic features. The male-to-female ratio was 10:1. Twenty five patients presented with X-SCID symptoms. Only one patient was diagnosed before the onset of symptoms due to positive family history. The mean time of delay in the diagnosis of X-SCID was 2.69 months (range, 0.5-8.67). Thirty-seven of the 44 patients died by the end of 2011 with the mean age of death being 7.87 months (range, 1.33-31). Six patients received hematopoietic stem cell transplantation (HSCT); only one of them survived, who was transplanted twice. The time between onset and death was shorter in the HSCT-treated group compared with the untreated group (2.87 ± 1.28 and 3.34 ± 0.59 months, respectively), probably due to active infections during transplantation. Bacillus Calmette-Guérin (BCG) complications occurred in 14 of the 34 patients who received BCG vaccination. Transfusion-induced graft-versus-host disease occurred in 5 patients. Total 20 mutations in interleukin-2 receptor subunit gamma (IL2RG) were identified in 22 patients, including 11 novel mutations. Most patients were misdiagnosed before referred to our SCID Center. Therefore, establishing more diagnostic centers dedicated to the care of PID and accessible by primary immunodeficiency patients will facilitate early, correct diagnosis and better care of SCID in China.

  19. Novel intelligent PID control of traveling wave ultrasonic motor.

    PubMed

    Jingzhuo, Shi; Yu, Liu; Jingtao, Huang; Meiyu, Xu; Juwei, Zhang; Lei, Zhang

    2014-09-01

    A simple control strategy with acceptable control performance can be a good choice for the mass production of ultrasonic motor control system. In this paper, through the theoretic and experimental analyses of typical control process, a simpler intelligent PID speed control strategy of TWUM is proposed, involving only two expert rules to adjust the PID control parameters based on the current status. Compared with the traditional PID controller, this design requires less calculation and more cheap chips which can be easily involved in online performance. Experiments with different load torques and voltage amplitudes show that the proposed controller can deal with the nonlinearity and load disturbance to maintain good control performance of TWUM.

  20. Gene therapy for primary immunodeficiencies: Part 1.

    PubMed

    Cavazzana-Calvo, Marina; Fischer, Alain; Hacein-Bey-Abina, Salima; Aiuti, Alessandro

    2012-10-01

    Over 60 patients affected by SCID due to IL2RG deficiency (SCID-X1) or adenosine deaminase (ADA)-SCID have received hematopoietic stem cell gene therapy in the past 15 years using gammaretroviral vectors, resulting in immune reconstitution and clinical benefit in the majority of them. However, the occurrence of insertional oncogenesis in the SCID-X1 trials has led to the development of new clinical trials based on integrating vectors with improved safety design as well as investigation on new technologies for highly efficient gene targeting and site-specific gene editing. Here we will present the experience and perspectives of gene therapy for SCID-X1 and ADA-SCID and discuss the pros and cons of gene therapy in comparison to allogeneic transplantation.

  1. [Radiographic changes in children with primary immunodeficiency].

    PubMed

    González-Uribe, Víctor; Pietropaolo-Cienfuegos, Dino Roberto; Del Río-Navarro, Blanca Estela; Del Río-Chivardi, Jaime Mariano; Sienra-Monge, Juan José Luis

    2015-01-01

    Antecedentes: si bien se cuenta con información epidemiológica de las inmunodeficiencias primarias, la información disponible en México es escasa. Objetivos: dar información epidemiológica del retraso del diagnóstico de las inmunodeficiencias primarias y de su correlación con daño pulmonar crónico. Material y método: estudio retrospectivo, analítico, efectuado en pacientes de 0 a 18 años de edad con diagnóstico de inmunodeficiencias primarias durante 11 años en el Hospital Infantil de México Federico Gómez; las variables estudiadas fueron: edad al inicio de los síntomas, edad al diagnóstico, tiempo desde el inicio de los síntomas al diagnóstico, número de neumonías previas y estudios radiográficos con datos de daño pulmonar crónico. Resultados: se incluyeron 48 pacientes que cumplieron los criterios de inclusión; 33 tenían daño pulmonar al diagnóstico, el déficit de anticuerpos fue el grupo con mayor afectación. Al correlacionar la edad de inicio de los síntomas y la diferencia de tiempo del inicio de los síntomas al diagnóstico se obtuvo una fuerte correlación (p <0.001, Rho > 0.80). Se observó una correlación moderada entre la diferencia en tiempo vs número de neumonías (p=0.005, Rho=0.495) y la correlación entre número de neumonías y daño pulmonar mostró significación alta (p <0.001, Rho=0.704). Conclusión: se encontró una relación estrecha entre el tiempo transcurrido desde el inicio de los síntomas y el número de neumonías con el daño pulmonar, por lo que las neumonías de repetición (más de dos) deben hacer sospechar el diagnóstico de inmunodeficiencia primaria, como se recomienda en la bibliografía mundial.

  2. Fuzzy PID controller combines with closed-loop optimal fuzzy reasoning for pitch control system

    NASA Astrophysics Data System (ADS)

    Li, Yezi; Xiao, Cheng; Sun, Jinhao

    2013-03-01

    PID and fuzzy PID controller are applied into the pitch control system. PID control has simple principle and its parameters setting are rather easy. Fuzzy control need not to establish the mathematical of the control system and has strong robustness. The advantages of fuzzy PID control are simple, easy in setting parameters and strong robustness. Fuzzy PID controller combines with closed-loop optimal fuzzy reasoning (COFR), which can effectively improve the robustness, when the robustness is special requirement. MATLAB software is used for simulations, results display that fuzzy PID controller which combines with COFR has better performances than PID controller when errors exist.

  3. Chronic inflammatory demyelinating polyneuropathy in common variable immunodeficiency.

    PubMed

    Özdemir, Özlem; Okan, Mehmet S; Kilic, Sara S

    2012-04-01

    Common variable immunodeficiency comprises a heterogeneous group of primary antibody deficiencies with complex clinical and immunologic phenotypes. Immune dysregulation leads to the generation of multiple autoantibodies against various antigenic targets in patients with common variable immunodeficiency. Chronic inflammatory demyelinating polyneuropathy is a heterogeneous disorder that indicates an autoimmune response against peripheral nerve myelin. We describe a 7-year-old girl with common variable immunodeficiency who developed chronic inflammatory polyneuropathy. A 5-day course of intravenous immunoglobulin (500 mg/kg/day) improved her neurologic disorder. Chronic inflammatory demyelinating polyneuropathy should be added to the broadening spectrum of neurologic complications in common variable immunodeficiency. Early detection and consequent treatment may reverse the neurologic sequelae.

  4. Noninfectious Granulomas: A Sign of an Underlying Immunodeficiency?

    PubMed

    Shoimer, Ilya; Wright, Nicola; Haber, Richard M

    2016-05-01

    Primary immunodeficiency disorders, such as ataxia-telangiectasia (A-T), may rarely be associated with cutaneous granulomas without an identifiable infection. The authors report a case of a 3-year-old boy with A-T who presented with two persistent ulcerated erythematous nodules. Histopathology was consistent with a granulomatous process secondary to A-T, without an infectious origin. Partial improvement was noted with clobetasol propionate 0.05% cream applied twice daily under occlusion. Of note, the presence of multiple noninfectious granulomas in a child may be the initial sign of an immune deficiency and should alert the astute clinician to investigate for an underlying primary immunodeficiency. Herein, the authors discuss the associations of noninfectious granulomas and primary immunodeficiency disorders and present management options for these difficult-to-treat lesions.

  5. Computation of robustly stabilizing PID controllers for interval systems.

    PubMed

    Matušů, Radek; Prokop, Roman

    2016-01-01

    The paper is focused on the computation of all possible robustly stabilizing Proportional-Integral-Derivative (PID) controllers for plants with interval uncertainty. The main idea of the proposed method is based on Tan's (et al.) technique for calculation of (nominally) stabilizing PI and PID controllers or robustly stabilizing PI controllers by means of plotting the stability boundary locus in either P-I plane or P-I-D space. Refinement of the existing method by consideration of 16 segment plants instead of 16 Kharitonov plants provides an elegant and efficient tool for finding all robustly stabilizing PID controllers for an interval system. The validity and relatively effortless application of presented theoretical concepts are demonstrated through a computation and simulation example in which the uncertain mathematical model of an experimental oblique wing aircraft is robustly stabilized.

  6. AIDS: acquired immunodeficiency syndrome.

    PubMed Central

    Gilmore, N. J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1983-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of utmost importance. PMID:6342737

  7. AIDS: acquired immunodeficiency syndrome *

    PubMed Central

    Gilmore, N.J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1992-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of the utmost importance. PMID:1544049

  8. Modeling and Implementation of PID Control for Autonomous Robots

    DTIC Science & Technology

    2007-06-01

    software based in digital control systems. The first applications of PID control were through pneumatic controllers in chemical processing industries...the error at the time. To exit, click the “Quit” button. Any data in the program will be lost. 53 LIST OF REFERENCES Bishop, Robert , and...Belmont, California: Brooks/Cole- Thomson Learning, 2004. Miller, R. M. et al. “A Long Range Predictive PID Controller with Application to an

  9. Variable Structure PID Control to Prevent Integrator Windup

    NASA Technical Reports Server (NTRS)

    Hall, C. E.; Hodel, A. S.; Hung, J. Y.

    1999-01-01

    PID controllers are frequently used to control systems requiring zero steady-state error while maintaining requirements for settling time and robustness (gain/phase margins). PID controllers suffer significant loss of performance due to short-term integrator wind-up when used in systems with actuator saturation. We examine several existing and proposed methods for the prevention of integrator wind-up in both continuous and discrete time implementations.

  10. Design and tuning of robust PID controller for HVAC systems

    SciTech Connect

    Kasahara, Masato; Matsuba, Tadahiko; Kuzuu, Yoshiaki; Yamazaki, Takanori; Hashimoto, Yukihiro; Kamimura, Kazuyuki; Kurosu, Shigeru

    1999-07-01

    This paper concerns the development of a new design and tuning method for use with robust proportional-plus-integral-plus-derivative (PID) controllers that are commonly used in the heating, ventilating, and air-conditioning (HVAC) fields. The robust PID controller is designed for temperature control of a single-zone environmental space. Although the dynamics of environmental space are described by higher-order transfer functions, most HVAC plants are approximated by first-order lag plus deadtime systems. Its control performance is examined for this commonly approximated controlled plant. Since most HVAC plants are complex with nonlinearity, distributed parameters, and multivariables, a single set of PID gains does not necessarily yield a satisfactory control performance. For this reason, the PID controller must be designed as a robust control system considering model uncertainty caused by changes in characteristics of the plant. The PID gains obtained by solving a two-disk type of mixed sensitivity problem can be modified by contrast to those tuned by the traditional Ziegler-Nichols rule. The results, which are surprisingly simple, are given as linear functions of ratio of deadtime to time constant for robustness. The numerical simulation and the experiments on a commercial-size test plant for air conditioning suggest that the robust PID controller proposed in this paper is effective enough for practical applications.

  11. The focusing DIRC: An innovative PID detector

    NASA Astrophysics Data System (ADS)

    Borsato, M.; Arnaud, N.; Dey, B.; Nishimura, K.; Leith, D. W. G. S.; Roberts, D.; Ratcliff, B.; Va'vra, J.; Varner, G. S.

    2013-12-01

    The FDIRC (Focusing Detector of Internally Reflected Cherenkov light) is a new concept of PID (Particle IDentification) detector aimed at separating kaons from pions up to a few GeV/c. It is the successor of the BABAR DIRC and benefits from the knowledge accumulated with a first FDIRC prototype built and operated at SLAC. The FDIRC is intended to be used in an environment with a luminosity 100 times higher than for BABAR and Belle. Backgrounds will be higher as well; yet, the FDIRC has been designed to perform at least as well as the BABAR DIRC. The main improvement is a complete redesign of the photon camera, moving from a huge tank of ultra-pure water to much smaller focusing cameras with solid fused-silica optics. Furthermore, the detection chain will be 10 times faster than in BABAR to reject more background and to measure more accurately Cherenkov angles. This is achieved using H-8500 MaPMTs and a new front-end electronics (FEE) with significantly improved timing precision, higher hit rate capability, and small dead time. A full-scale FDIRC prototype covering 1/12th of the barrel azimuth is installed at SLAC and has just started recording cosmic-ray data. In this paper, we summarize the FDIRC design, present the status of the prototype test at SLAC and review the ongoing work to analyse the data.

  12. PID feedback control of monochromator thermal stabilization

    NASA Astrophysics Data System (ADS)

    Yoder, Derek W.; Makarov, Oleg; Corcoran, Stephen; Fischetti, Robert F.

    2011-09-01

    The desire for increasingly smaller X-ray beams for macromolecular crystallography experiments also stimulates the need for improvements in beam stability. There are numerous sources of instability, which influence beam quality on the micron-size scale. Typically, the most problematic source is thermal drift within the double crystal monochromators. In addition to using liquid nitrogen to indirectly cool both the first and second crystals, GM/CA-CAT previously used a combination of flowing water at constant temperature and copper braiding to stabilize the mechanics, mounts, and the Compton scatter shielding. However, the copper braids inefficiently stabilized the temperature of components that were distant from the water lines. Additionally, vibrations in the water lines propagated throughout the vibrationally dampened monochromator, thereby introducing both positional and intensity instabilities in the transmitted X-ray beam. To address these problems, heating pads were placed directly onto the temperature-sensitive components, with output controlled by a PID-feedback loop. As a result, there is negligible temperature change in the first crystal radiation shielding over the entire range of operational heat loads. Additionally, the angular drift in the second crystal induced by temperature changes in other components is dramatically decreased.

  13. Identifying Mutations of the Tetratricopeptide Repeat Domain 37 (TTC37) Gene in Infants With Intractable Diarrhea and a Comparison of Asian and Non-Asian Phenotype and Genotype: A Global Case-report Study of a Well-Defined Syndrome With Immunodeficiency.

    PubMed

    Lee, Wen-I; Huang, Jing-Long; Chen, Chien-Chang; Lin, Ju-Li; Wu, Ren-Chin; Jaing, Tang-Her; Ou, Liang-Shiou

    2016-03-01

    Syndromic diarrhea/tricho-hepato-enteric syndrome (SD/THE) is a rare, autosomal recessive and severe bowel disorder mainly caused by mutations in the tetratricopeptide repeat domain 37 (TTC37) gene which act as heterotetrameric cofactors to enhance aberrant mRNAs decay. The phenotype and immune profiles of SD/THE overlap those of primary immunodeficiency diseases (PIDs). Neonates with intractable diarrhea underwent immunologic assessments including immunoglobulin levels, lymphocyte subsets, lymphocyte proliferation, superoxide production, and IL-10 signaling function. Candidate genes for PIDs predisposing to inflammatory bowel disease were sequencing in this study. Two neonates, born to nonconsanguineous parents, suffered from intractable diarrhea, recurrent infections, and massive hematemesis from esopharyngeal varices due to liver cirrhosis or accompanying Trichorrhexis nodosa that developed with age and thus guided the diagnosis of SD/THE compatible to TTC37 mutations (homozygous DelK1155H, Fs*2; heterozygous Y1169Ter and InsA1143, Fs*3). Their immunologic evaluation showed normal mitogen-stimulated lymphocyte proliferation, superoxide production, and IL-10 signaling, but low IgG levels, undetectable antibody to hepatitis B surface antigen and decreased antigen-stimulated lymphocyte proliferation. A PubMed search for bi-allelic TTC37 mutations and phenotypes were recorded in 14 Asian and 12 non-Asian cases. They had similar presentations of infantile onset refractory diarrhea, facial dysmorphism, hair anomalies, low IgG, low birth weight, and consanguinity. A higher incidence of heart anomalies (8/14 vs 2/12; P = 0.0344, Chi-square), nonsense mutations (19 in 28 alleles), and hot-spot mutations (W936Ter, 2779-2G>A, and Y1169Ter) were found in the Asian compared with the non-Asian patients. Despite immunoglobulin therapy in 20 of the patients, 4 died from liver cirrhosis and 1 died from sepsis. Patients of all ethnicities with SD/THE with the characteristic

  14. A conserved two-component regulatory system, PidS/PidR, globally regulates pigmentation and virulence-related phenotypes of Burkholderia glumae.

    PubMed

    Karki, Hari Sharan; Barphagha, Inderjit Kaur; Ham, Jong Hyun

    2012-09-01

    Burkholderia glumae is a rice pathogenic bacterium that causes bacterial panicle blight. Some strains of this pathogen produce dark brown pigments when grown on casamino-acid peptone glucose (CPG) agar medium. A pigment-positive and highly virulent strain of B. glumae, 411gr-6, was randomly mutagenized with mini-Tn5gus, and the resulting mini-Tn5gus derivatives showing altered pigmentation phenotypes were screened on CPG agar plates to identify the genetic elements governing the pigmentation of B. glumae. In this study, a novel two-component regulatory system (TCRS) composed of the PidS sensor histidine kinase and the PidR response regulator was identified as an essential regulatory factor for pigmentation. Notably, the PidS/PidR TCRS was also required for the elicitation of the hypersensitive response on tobacco leaves, indicating the dependence of the hypersensitive response and pathogenicity (Hrp) type III secretion system of B. glumae on this regulatory factor. In addition, B. glumae mutants defective in the PidS/PidR TCRS showed less production of the phytotoxin, toxoflavin, and less virulence on rice panicles and onion bulbs relative to the parental strain, 411gr-6. The presence of highly homologous PidS and PidR orthologues in other Burkholderia species suggests that PidS/PidR-family TCRSs may exert the same or similar functions in different Burkholderia species, including both plant and animal pathogens.

  15. Learning about Severe Combined Immunodeficiency (SCID)

    MedlinePlus

    ... immunodeficiency From The Journal of Allergy and Clinical Immunology Learning About Severe Combined Immunodeficiency (SCID) What is ... immunodeficiency From The Journal of Allergy and Clinical Immunology Get Email Updates Advancing human health through genomics ...

  16. [Food protective property of new liquid food container PID (Pouch in Dispenser) for microbes].

    PubMed

    Tominari, Keita; Tanaka, Asato; Shinoda, Yuma; Futase, Katsunori; Nei, Daisuke; Isshiki, Kenji

    2011-01-01

    We examined the content protection characteristics of the PID (Pouch in Dispenser) when it was used in the usual manner and when it was polluted artificially. When the PID was used in the usual manner, the nozzle was opened, and experiments were carried out with and without air-blowing. The invasion of bacteria into the PID was not detected. Also, no bacteria were detected in the material poured from the nozzle of the PID. When 3 strains of bacteria suspensions were intentionally smeared on the nozzle of the PID, invasion of bacteria was observed. When the PID was wiped with a dirty cloth, no invasion of bacteria into the PID was detected. It may be necessary to label the PID with the instruction that the nozzle should not be touched. The effected of changes in the water activity and pH, and the preservatives used, may also need to be considered, depending on the contents in the PID.

  17. Immunodeficiency and autoimmune enterocolopathy linked to NFAT5 haploinsufficiency.

    PubMed

    Boland, Brigid S; Widjaja, Christella E; Banno, Asoka; Zhang, Bing; Kim, Stephanie H; Stoven, Samantha; Peterson, Michael R; Jones, Marilyn C; Su, H Irene; Crowe, Sheila E; Bui, Jack D; Ho, Samuel B; Okugawa, Yoshinaga; Goel, Ajay; Marietta, Eric V; Khosroheidari, Mahdieh; Jepsen, Kristen; Aramburu, Jose; López-Rodríguez, Cristina; Sandborn, William J; Murray, Joseph A; Harismendy, Olivier; Chang, John T

    2015-03-15

    The link between autoimmune diseases and primary immunodeficiency syndromes has been increasingly appreciated. Immunologic evaluation of a young man with autoimmune enterocolopathy and unexplained infections revealed evidence of immunodeficiency, including IgG subclass deficiency, impaired Ag-induced lymphocyte proliferation, reduced cytokine production by CD8(+) T lymphocytes, and decreased numbers of NK cells. Genetic evaluation identified haploinsufficiency of NFAT5, a transcription factor regulating immune cell function and cellular adaptation to hyperosmotic stress, as a possible cause of this syndrome. Inhibition or deletion of NFAT5 in normal human and murine cells recapitulated several of the immune deficits identified in the patient. These results provide evidence of a primary immunodeficiency disorder associated with organ-specific autoimmunity linked to NFAT5 deficiency.

  18. Immunodeficiency and Autoimmune Enterocolopathy Linked to NFAT5 Haploinsufficiency

    PubMed Central

    Boland, Brigid S.; Widjaja, Christella E.; Banno, Asoka; Zhang, Bing; Kim, Stephanie H.; Stoven, Samantha; Peterson, Michael R.; Jones, Marilyn C.; Su, H. Irene; Crowe, Sheila E.; Bui, Jack D.; Ho, Samuel B.; Okugawa, Yoshinaga; Goel, Ajay; Marietta, Eric V.; Khosroheidari, Mahdieh; Jepsen, Kristen L.; Aramburu, Jose; Lopez-Rodriguez, Cristina; Sandborn, William J.; Murray, Joseph A.; Harismendy, Olivier; Chang, John T.

    2015-01-01

    The link between autoimmune diseases and primary immunodeficiency syndromes has been increasingly appreciated. Immunologic evaluation of a young man with autoimmune enterocolopathy and unexplained infections revealed evidence of immunodeficiency, including IgG subclass deficiency, impaired antigen-induced lymphocyte proliferation, reduced cytokine production by CD8+ T lymphocytes, and decreased numbers of natural killer (NK) cells. Genetic evaluation identified haploinsufficiency of NFAT5, a transcription factor regulating immune cell function and cellular adaptation to hyperosmotic stress, as a possible cause of this syndrome. Inhibition or deletion of NFAT5 in normal human and murine cells recapitulated several of the immune deficits identified in the patient. These results provide evidence of a primary immunodeficiency disorder associated with organ-specific autoimmunity linked to NFAT5 deficiency. PMID:25667416

  19. [HIV infection and acquired immunodeficiency syndrome].

    PubMed

    Takamatsu, J

    1997-05-01

    On June 4, 1981, MMWR published a report about Pneumocystis carinii pneumonia in homosexual men in Los Angeles. This was the first published report. A years later, this disease was named acquired immunodeficiency syndrome (AIDS). In the following year, Montangier et al in France discovered the causative agent, which they called lymphadenopathy virus (LAV), now known as human immunodeficiency virus (HIV). In 1985, solid-phase enzymeimmunoassay for the detection of the antibody to HIV was developed. Since then, other new techniques for the identification of HIV infection have been become available. These include more sensitive methods (for example; polymerase chain reaction techniques). Although these techniques facilitate early and definite diagnosis of infection, these tests may fail to detect the antibody in sera during window period of infection or overdiagnose infection in sera contaminated with genes not related to HIV. Although preventing blood exposure is the primary means of preventing occupationally acquired human immunodeficiency virus (HIV) infection, appropriate post-exposure management is an important element of workplace safety. Information suggesting that zidovudine (ZDV) postexposure prophylaxis (PEP) may reduce the risk for HIV transmission after occupational exposure to HIV infected blood prompted a Public Health Service (PHS) interagency working group, with expert consultation, and recommendations on PEP and management of occupational exposure to HIV in relation to these findings were discussed.

  20. Immunodeficiencies caused by infectious diseases.

    PubMed

    Sykes, Jane E

    2010-05-01

    Immunodeficiencies caused by infectious agents may result from disruption of normal host barriers or dysregulation of cellular immunity, the latter serving to promote survival of the infectious agent through immune evasion. Such infections may be followed by opportunistic infections with a variety of other microorganisms. Classic infectious causes of immunodeficiency in companion animals are the immunodeficiency retroviruses, including feline immunodeficiency virus and feline leukemia virus. Other important causes include canine distemper virus; canine parvovirus 2; feline infectious peritonitis virus; rickettsial organisms that infect leukocytes; Leishmania; and fungal pathogens, such as Cryptococcus. Considerable research effort has been invested in understanding the mechanisms of pathogen-induced immunosuppression, with the hope that effective therapies may be developed that reverse the immunodeficiencies developed and in turn assist the host to clear persistent or life-threatening infectious diseases.

  1. Space Flight Immunodeficiency

    NASA Technical Reports Server (NTRS)

    Shearer, William T.

    1999-01-01

    The National Aeronautics and Space Administration (NASA) has had sufficient concern for the well-being of astronauts traveling in space to create the National Space Biomedical Research Institute (NSBRI), which is investigating several areas of biomedical research including those of immunology. As part of the Immunology, Infection, and Hematology Team, the co-investigators of the Space Flight Immunodeficiency Project began their research projects on April 1, 1998 and are now just into the second year of work. Two areas of research have been targeted: 1) specific immune (especially antibody) responses and 2) non-specific inflammation and adhesion. More precise knowledge of these two areas of research will help elucidate the potential harmful effects of space travel on the immune system, possibly sufficient to create a secondary state of immunodeficiency in astronauts. The results of these experiments are likely to lead to the delineation of functional alterations in antigen presentation, specific immune memory, cytokine regulation of immune responses, cell to cell interactions, and cell to endothelium interactions.

  2. Pattern recognition and PID procedure with the ALICE-HMPID

    NASA Astrophysics Data System (ADS)

    Volpe, Giacomo

    2014-12-01

    The ALICE apparatus is dedicated to the study of pp, p-Pb and Pb-Pb collisions provided by LHC. ALICE has unique particle identification (PID) capabilities among the LHC experiments exploiting different PID techniques, i.e., energy loss, time-of-flight measurements, Cherenkov and transition radiation detection, calorimetry and topological ID. The ALICE-HMPID is devoted to the identification of charged hadrons. It consists of seven identical RICH counters, with liquid C6F14 as Cherenkov radiator (n≈1.299 at λph=175 nm). Photons and charged particles detection is performed by a proportional chamber, coupled with a pad segmented CsI coated photo-cathode. In pp and p-Pb events HMPID provides 3 sigmas separation for pions and kaons up to pT = 3 GeV / c and for protons up to pT = 5 GeV / c. PID is performed by means of photon emission angle measurement, a challenging task in the high multiplicity environment of the most central Pb-Pb collisions. A dedicated algorithm has been implemented to evaluate the Cherenkov angle starting from the bi-dimensional ring pattern on the photons detector, it is based on the Hough Transform Method (HTM) to separate signal from background. In this way HMPID is able to contribute to inclusive hadrons spectra measurement as well as to measurements where high purity PID is required, by means of statistical or track-by-track PID. The pattern recognition, the results from angular resolution studies and the PID strategy with HMPID are presented.

  3. Feline immunodeficiency virus latency

    PubMed Central

    2013-01-01

    Despite highly effective anti-retroviral therapy, HIV is thought to persist in patients within long-lived cellular reservoirs in the form of a transcriptionally inactive (latent) integrated provirus. Lentiviral latency has therefore come to the forefront of the discussion on the possibility of a cure for HIV infection in humans. Animal models of lentiviral latency provide an essential tool to study mechanisms of latency and therapeutic manipulation. Of the three animal models that have been described, the feline immunodeficiency virus (FIV)-infected cat is the most recent and least characterized. However, several aspects of this model make it attractive for latency research, and it may be complementary to other model systems. This article reviews what is known about FIV latency and chronic FIV infection and how it compares with that of other lentiviruses. It thereby offers a framework for the usefulness of this model in future research aimed at lentiviral eradication. PMID:23829177

  4. Late Onset Combined Immunodeficiency Presenting with Recurrent Pneumocystis jiroveci Pneumonia

    PubMed Central

    Baraboutis, Ioannis G.; Karnesis, Lazaros

    2014-01-01

    Late onset combined immunodeficiency (LOCID) is a recently described variant of common variable immunodeficiency (CVID), involving adult patients presenting with opportunistic infections and/or low CD4+ lymphocyte counts. A 36-year-old male with unremarkable past medical history presented with fever, respiratory failure, and lymphocytopenia. He was found to have Pneumocystis jiroveci pneumonia (PJP), subsequently complicated by recurrent hospital-acquired Pseudomonas aeruginosa pneumonia and immune reconstitution phenomena, attributed to restoration of immunoglobulin levels. Clinicians should be aware of LOCID, which could be confused with HIV infection/AIDS or idiopathic CD4 lymphocytopenia. In the English bibliography there is only one case report, where PJP was the initial presentation of CVID (that case would probably be classified as LOCID). Phenomena of immune reconstitution are described in various settings, including primary immunodeficiency, manifesting as temporary clinical and radiologic deterioration and leading to misperceptions of therapeutic failure and/or presence of alternative/additional diagnoses. PMID:24799913

  5. Bidimensional MRI-based navigation system using a PID controller.

    PubMed

    Tamaz, Samer; Gourdeau, Richard; Martel, Sylvain

    2006-01-01

    The feasibility of using 2D real-time control to navigate ferromagnetic entities in an MRI bore for novel medical interventions is assessed. Preliminary experimental results confirm that a simple PID controller can be suitable for several applications where targeting out-of-reach locations within the cardiovascular system is essential.

  6. Design of a PID Controller for a PCR Micro Reactor

    ERIC Educational Resources Information Center

    Dinca, M. P.; Gheorghe, M.; Galvin, P.

    2009-01-01

    Proportional-integral-derivative (PID) controllers are widely used in process control, and consequently they are described in most of the textbooks on automatic control. However, rather than presenting the overall design process, the examples given in such textbooks are intended to illuminate specific focused aspects of selection, tuning and…

  7. All About PID - Testing and Avoidance in the Field

    SciTech Connect

    Hacke, Peter; Johnston, Steve

    2016-09-01

    Potential-induced degradation can cause significant power loss in modules if the appropriate precautions are not taken. In the first part of a new series in PV Tech Power on module failure, Peter Hacke and Steve Johnston assess the current state-of-the-art in detecting, avoiding and mitigating the worst effects of PID.

  8. Comparative analysis of PSO algorithms for PID controller tuning

    NASA Astrophysics Data System (ADS)

    Štimac, Goranka; Braut, Sanjin; Žigulić, Roberto

    2014-09-01

    The active magnetic bearing(AMB) suspends the rotating shaft and maintains it in levitated position by applying controlled electromagnetic forces on the rotor in radial and axial directions. Although the development of various control methods is rapid, PID control strategy is still the most widely used control strategy in many applications, including AMBs. In order to tune PID controller, a particle swarm optimization(PSO) method is applied. Therefore, a comparative analysis of particle swarm optimization(PSO) algorithms is carried out, where two PSO algorithms, namely (1) PSO with linearly decreasing inertia weight(LDW-PSO), and (2) PSO algorithm with constriction factor approach(CFA-PSO), are independently tested for different PID structures. The computer simulations are carried out with the aim of minimizing the objective function defined as the integral of time multiplied by the absolute value of error(ITAE). In order to validate the performance of the analyzed PSO algorithms, one-axis and two-axis radial rotor/active magnetic bearing systems are examined. The results show that PSO algorithms are effective and easily implemented methods, providing stable convergence and good computational efficiency of different PID structures for the rotor/AMB systems. Moreover, the PSO algorithms prove to be easily used for controller tuning in case of both SISO and MIMO system, which consider the system delay and the interference among the horizontal and vertical rotor axes.

  9. Thermostatic system of sensor in NIR spectrometer based on PID control

    NASA Astrophysics Data System (ADS)

    Wang, Zhihong; Qiao, Liwei; Ji, Xufei

    2016-11-01

    Aiming at the shortcomings of the primary sensor thermostatic control system in the near infrared (NIR) spectrometer, a novel thermostatic control system based on proportional-integral-derivative (PID) control technology was developed to improve the detection precision of the NIR spectrometer. There were five parts including bridge amplifier circuit, analog-digital conversion (ADC) circuit, microcontroller, digital-analog conversion (DAC) circuit and drive circuit in the system. The five parts formed a closed-loop control system based on PID algorithm that was used to control the error between the temperature calculated by the sampling data of ADC and the designed temperature to ensure the stability of the spectrometer's sensor. The experimental results show that, when the operating temperature of sensor is -11°, compared with the original system, the temperature control precision of the new control system is improved from ±0.64° to ±0.04° and the spectrum signal to noise ratio (SNR) is improved from 4891 to 5967.

  10. A Novel Technique for Performing PID Susceptibility Screening during the Solar Cell Fabrication Process

    SciTech Connect

    Oh, Jaewon; Dahal, Som; Dauksher, Bill; Bowden, Stuart; Tamizhmani, Govindasamy; Hacke, Peter

    2016-11-21

    Various characterization techniques have historically been developed in order to screen potential induced degradation (PID)-susceptible cells, but those techniques require final solar cells. We present a new characterization technique for screening PID-susceptible cells during the cell fabrication process. Illuminated Lock-In Thermography (ILIT) was used to image PID shunting of the cell without metallization and clearly showed PID-affected areas. PID-susceptible cells can be screened by ILIT, and the sample structure can advantageously be simplified as long as the sample has the silicon nitride antireflection coating and an aluminum back surface field.

  11. Design and implementation of a 2-DOF PID compensation for magnetic levitation systems.

    PubMed

    Ghosh, Arun; Rakesh Krishnan, T; Tejaswy, Pailla; Mandal, Abhisek; Pradhan, Jatin K; Ranasingh, Subhakant

    2014-07-01

    This paper employs a 2-DOF (degree of freedom) PID controller for compensating a physical magnetic levitation system. It is shown that because of having a feedforward gain in the proposed 2-DOF PID control, the transient performance of the compensated system can be changed in a desired manner unlike the conventional 1-DOF PID control. It is also shown that for a choice of PID parameters, although the theoretical loop robustness is the same for both the compensated systems, in real-time, 2-DOF PID control may provide superior robustness if a suitable choice of the feedforward parameter is made. The results are verified through simulations and experiments.

  12. Hybrid PID and PSO-based control for electric power assist steering system for electric vehicle

    NASA Astrophysics Data System (ADS)

    Hanifah, R. A.; Toha, S. F.; Ahmad, S.

    2013-12-01

    Electric power assist steering (EPAS) system provides an important significance in enhancing the driving performance of a vehicle with its energy-conserving features. This paper presents a hybrid PID (Proportional-Integral-Derivative) and particle swarm optimization (PSO) based control scheme to minimize energy consumption for EPAS. This single objective optimization scheme is realized using the PSO technique in searching for best gain parameters of the PID controller. The fast tuning feature of this optimum PID controller produced high-quality solutions. Simulation results show the performance and effectiveness of the hybrid PSO-PID based controller as opposed to the conventional PID controller.

  13. Immunodeficiency in Patients With 49,XXXXY Chromosomal Variation

    PubMed Central

    Keller, Michael D.; Sadeghin, Teresa; Samango-Sprouse, Carole; Orange, Jordan S.

    2016-01-01

    Boys affected with 49,XXXXY sex chromosomal variation have been described to have high incidence of recurrent otitis media and asthma, the cause of which is unknown. We hypothesized that primary immunodeficiency occurs in patients with XXXXY aneuploidy. To investigate this, 31 boys with known 49,XXXXY were evaluated through a multidisciplinary clinic. Screening history was performed using the “10 Warning Signs of primary immunodeficiency” (Jeffrey Modell Foundation), as well as by history of atopic and autoimmune conditions. Of the 31 boys, 20 had at least two warning signs of primary immunodeficiency, and five had four or more signs. Sixteen had history of recurrent pneumonia, and 15 carried the diagnosis of asthma. Of the 10 who underwent immunologic screening, eight showed some evidence of impaired antibody responses to polysaccharide antigens, and one was diagnosed with specific antibody deficiency. These preliminary results suggest a high incidence of both atopy and antibody deficiency in boys with 49,XXXXY. PMID:23345259

  14. Evaluation of Severe Combined Immunodeficiency and Combined Immunodeficiency Pediatric Patients on the Basis of Cellular Radiosensitivity

    PubMed Central

    Lobachevsky, Pavel; Woodbine, Lisa; Hsiao, Kuang-Chih; Choo, Sharon; Fraser, Chris; Gray, Paul; Smith, Jai; Best, Nickala; Munforte, Laura; Korneeva, Elena; Martin, Roger F.; Jeggo, Penny A.; Martin, Olga A.

    2016-01-01

    Pediatric patients with severe or nonsevere combined immunodeficiency have increased susceptibility to severe, life-threatening infections and, without hematopoietic stem cell transplantation, may fail to thrive. A subset of these patients have the radiosensitive (RS) phenotype, which may necessitate conditioning before hematopoietic stem cell transplantation, and this conditioning includes radiomimetic drugs, which may significantly affect treatment response. To provide statistical criteria for classifying cellular response to ionizing radiation as the measure of functional RS screening, we analyzed the repair capacity and survival of ex vivo irradiated primary skin fibroblasts from five dysmorphic and/or developmentally delayed pediatric patients with severe combined immunodeficiency and combined immunodeficiency. We developed a mathematical framework for the analysis of γ histone 2A isoform X foci kinetics to quantitate DNA-repair capacity, thus establishing crucial criteria for identifying RS. The results, presented in a diagram showing each patient as a point in a 2D RS map, were in agreement with findings from the assessment of cellular RS by clonogenic survival and from the genetic analysis of factors involved in the nonhomologous end-joining repair pathway. We provide recommendations for incorporating into clinical practice the functional assays and genetic analysis used for establishing RS status before conditioning. This knowledge would enable the selection of the most appropriate treatment regimen, reducing the risk for severe therapy-related adverse effects. PMID:26151233

  15. Evaluation of Severe Combined Immunodeficiency and Combined Immunodeficiency Pediatric Patients on the Basis of Cellular Radiosensitivity.

    PubMed

    Lobachevsky, Pavel; Woodbine, Lisa; Hsiao, Kuang-Chih; Choo, Sharon; Fraser, Chris; Gray, Paul; Smith, Jai; Best, Nickala; Munforte, Laura; Korneeva, Elena; Martin, Roger F; Jeggo, Penny A; Martin, Olga A

    2015-09-01

    Pediatric patients with severe or nonsevere combined immunodeficiency have increased susceptibility to severe, life-threatening infections and, without hematopoietic stem cell transplantation, may fail to thrive. A subset of these patients have the radiosensitive (RS) phenotype, which may necessitate conditioning before hematopoietic stem cell transplantation, and this conditioning includes radiomimetic drugs, which may significantly affect treatment response. To provide statistical criteria for classifying cellular response to ionizing radiation as the measure of functional RS screening, we analyzed the repair capacity and survival of ex vivo irradiated primary skin fibroblasts from five dysmorphic and/or developmentally delayed pediatric patients with severe combined immunodeficiency and combined immunodeficiency. We developed a mathematical framework for the analysis of γ histone 2A isoform X foci kinetics to quantitate DNA-repair capacity, thus establishing crucial criteria for identifying RS. The results, presented in a diagram showing each patient as a point in a 2D RS map, were in agreement with findings from the assessment of cellular RS by clonogenic survival and from the genetic analysis of factors involved in the nonhomologous end-joining repair pathway. We provide recommendations for incorporating into clinical practice the functional assays and genetic analysis used for establishing RS status before conditioning. This knowledge would enable the selection of the most appropriate treatment regimen, reducing the risk for severe therapy-related adverse effects.

  16. Neural PID Control of Robot Manipulators With Application to an Upper Limb Exoskeleton.

    PubMed

    Yu, Wen; Rosen, Jacob

    2013-04-01

    In order to minimize steady-state error with respect to uncertainties in robot control, proportional-integral-derivative (PID) control needs a big integral gain, or a neural compensator is added to the classical proportional-derivative (PD) control with a large derivative gain. Both of them deteriorate transient performances of the robot control. In this paper, we extend the popular neural PD control into neural PID control. This novel control is a natural combination of industrial linear PID control and neural compensation. The main contributions of this paper are semiglobal asymptotic stability of the neural PID control and local asymptotic stability of the neural PID control with a velocity observer which are proved with standard weight training algorithms. These conditions give explicit selection methods for the gains of the linear PID control. An experimental study on an upper limb exoskeleton with this neural PID control is addressed.

  17. PID: from material properties to outdoor performance and quality control counter measures

    NASA Astrophysics Data System (ADS)

    Berghold, J.; Koch, S.; Pingel, S.; Janke, S.; Ukar, A.; Grunow, P.; Shioda, T.

    2015-09-01

    Although the main root causes and referring counter measures for PID are known, a significant part of the industrial modules are still found to be PID sensitive in testing and PID is increasingly evident in field. This paper discusses field occurrence of PID with respect to environmental conditions and material properties. Different PID pattern in field and in test are analyzed in terms of the potential distribution and surface conductivity. Examples are given for the correlation of PID lab tests of a (commercial) BOM with real outdoor degradation. PID progress is predicted for different locations and compared with measurement data. Suitable quality control measures are discussed for the modules as well as for the encapsulation material

  18. An improved PID switching control strategy for type 1 diabetes.

    PubMed

    Marchetti, Gianni; Barolo, Massimiliano; Jovanovic, Lois; Zisser, Howard; Seborg, Dale E

    2006-01-01

    In order for an "artificial pancreas" to become a reality for ambulatory use, a practical closed-loop control strategy must be developed and critically evaluated. In this paper, an improved PID control strategy for blood glucose control is proposed and evaluated in silico using a physiologic model of Hovorka et al. The key features of the proposed control strategy are: (i) a switching strategy for initiating PID control after a meal and insulin bolus; (ii) a novel time-varying setpoint trajectory, (iii) noise and derivative filters to reduce sensitivity to sensor noise, and (iv) a systematic controller tuning strategy. Simulation results demonstrate that the proposed control strategy compares favorably to alternatives for realistic conditions that include meal challenges, incorrect carbohydrate meal estimates, changes in insulin sensitivity, and measurement noise.

  19. Two-level tuning of fuzzy PID controllers.

    PubMed

    Mann, G I; Hu, B G; Gosine, R G

    2001-01-01

    Fuzzy PID tuning requires two stages of tuning; low level tuning followed by high level tuning. At the higher level, a nonlinear tuning is performed to determine the nonlinear characteristics of the fuzzy output. At the lower level, a linear tuning is performed to determine the linear characteristics of the fuzzy output for achieving overall performance of fuzzy control. First, different fuzzy systems are defined and then simplified for two-point control. Non-linearity tuning diagrams are constructed for fuzzy systems in order to perform high level tuning. The linear tuning parameters are deduced from the conventional PID tuning knowledge. Using the tuning diagrams, high level tuning heuristics are developed. Finally, different applications are demonstrated to show the validity of the proposed tuning method.

  20. An improved PID switching control strategy for type 1 diabetes.

    PubMed

    Marchetti, Gianni; Barolo, Massimiliano; Jovanovic, Lois; Zisser, Howard; Seborg, Dale E

    2008-03-01

    In order for an "artificial pancreas" to become a reality for ambulatory use, a practical closed-loop control strategy must be developed and validated. In this paper, an improved PID control strategy for blood glucose control is proposed and critically evaluated in silico using a physiologic model of Hovorka et al. [1]. The key features of the proposed control strategy are: 1) a switching strategy for initiating PID control after a meal and insulin bolus; 2) a novel time-varying setpoint trajectory; 3) noise and derivative filters to reduce sensitivity to sensor noise; and 4) a practical controller tuning strategy. Simulation results demonstrate that proposed control strategy compares favorably to alternatives for realistic conditions that include meal challenges, incorrect carbohydrate meal estimates, changes in insulin sensitivity, and measurement noise.

  1. Primary Immune Deficiencies – Principles of Care

    PubMed Central

    Chapel, Helen; Prevot, Johan; Gaspar, Hubert Bobby; Español, Teresa; Bonilla, Francisco A.; Solis, Leire; Drabwell, Josina

    2014-01-01

    Primary immune deficiencies (PIDs) are a growing group of over 230 different disorders caused by ineffective, absent or an increasing number of gain of function mutations in immune components, mainly cells and proteins. Once recognized, these rare disorders are treatable and in some cases curable. Otherwise untreated PIDs are often chronic, serious, or even fatal. The diagnosis of PIDs can be difficult due to lack of awareness or facilities for diagnosis, and management of PIDs is complex. This document was prepared by a worldwide multi-disciplinary team of specialists; it aims to set out comprehensive principles of care for PIDs. These include the role of specialized centers, the importance of registries, the need for multinational research, the role of patient organizations, management and treatment options, the requirement for sustained access to all treatments including immunoglobulin therapies and hematopoietic stem cell transplantation, important considerations for developing countries and suggestions for implementation. A range of healthcare policies and services have to be put into place by government agencies and healthcare providers, to ensure that PID patients worldwide have access to appropriate and sustainable medical and support services. PMID:25566243

  2. Chronic Giardiasis in a Case of Common Variable Immunodeficiency (CVID): A Case Report

    PubMed Central

    Koticha, Avani; Mehta, Preeti R

    2016-01-01

    Common Variable Immunodeficiency (CVID) is a primary immunodeficiency characterized by low antibody levels and recurrent infections. This makes an individual more prone to recurrent respiratory and gastrointestinal tract infections. In cases where there is persistent positive finding of intestinal parasites in stool, a high index of suspicion should be raised to rule out immunodeficiency state. Early diagnosis of such cases will help in reducing the morbidity and better management of the patient. A case of CVID in 18-year-old male with recurrent lower respiratory tract infection and chronic diarrhoea due to Giardia lamblia is reported herewith. PMID:27630845

  3. Neonatal Screening for Severe Combined Immunodeficiency (SCID)

    PubMed Central

    Puck, Jennifer M.

    2012-01-01

    Purpose of review Population-based newborn screening for severe combined immunodeficiency (SCID) and related disorders has been instituted in five states, with several more planning to add this testing to their newborn screening panels. This review summarizes the rationale, development, and implementation of SCID screening programs to date and highlights current and future challenges. Recent findings Early results of T-cell receptor excision circle (TREC) testing newborns in pilot states indicate that this addition to the newborn screening panel can be successfully integrated into state public health programs. The TREC test has clinical validity and TRECs, as predicted, are an excellent biomarker of poor T-cell lymphocyte production in the thymus or increased lymphocyte loss resulting in T-cell lymphopenia. A variety of cases with typical SCID genotypes and other conditions have been detected in a timely manner and referred for appropriate early treatment. Summary Early detection of primary immunodeficiency is recognized as important for avoiding infectious complications that compromise outcomes. Routine screening of all newborns with the TREC test, implemented as part of an integrated public health program, can achieve pre-symptomatic diagnosis of SCID and other disorders with T-cell lymphopenia, allowing prompt and effective treatment and leading to a better understanding of the spectrum of these disorders and how to manage them. PMID:22001765

  4. [Immunological alterations in common variable immunodeficiency].

    PubMed

    Berrón-Ruiz, Laura

    2017-01-01

    Common variable immunodeficiency (CVID) is the largest group of symptomatic primary immune deficiencies; it is characterized by hypogammaglobulinemia, poor response to vaccines and increased susceptibility to infections. Cellular phenotypes and abnormalities have been described both in adaptive and innate immune response. Several classifications of common variable immunodeficiency are based on defects found on T and B cells, which have been correlated with clinical manifestations. In recent years, significant progress has been made in elucidating the genetic mechanisms that result in a IDCV phenotype. Massive sequencing technologies have favored the description of mutations in several genes, but only in 2 % to 10 % of patients. These monogenetic defects are: ICOS, TNFRSF13B (TACI), TNFRS13C (BAFFR), TNRFSF12 (TWEAK), CD19, CD81, CR2 (CD21), MS4A1 (CD20), (CD27), LRBA, CTLA4, PRKCD, PLCG2, NFKB1, NFKB2, PIK3CD, PIK3R, VAV1, RAC1, BLK, IKZF1 (IKAROS) and IRF2BP2. These findings have provided a possible explanation for the pathogenesis of IDCV, since these molecules play an important role in the co-operation between B and T cells in the germinal center, as well as in intrinsic signaling pathways of both.

  5. Severe combined immunodeficiency--an update.

    PubMed

    Cirillo, Emilia; Giardino, Giuliana; Gallo, Vera; D'Assante, Roberta; Grasso, Fiorentino; Romano, Roberta; Di Lillo, Cristina; Galasso, Giovanni; Pignata, Claudio

    2015-11-01

    Severe combined immunodeficiencies (SCIDs) are a group of inherited disorders responsible for severe dysfunctions of the immune system. These diseases are life-threatening when the diagnosis is made too late; they are the most severe forms of primary immunodeficiency. SCID patients often die during the first two years of life if appropriate treatments to reconstitute their immune system are not undertaken. Conventionally, SCIDs are classified according either to the main pathway affected by the molecular defect or on the basis of the specific immunologic phenotype that reflects the stage where the blockage occurs during the differentiation process. However, during the last few years many new causative gene alterations have been associated with unusual clinical and immunological phenotypes. Many of these novel forms of SCID also show extra-hematopoietic alterations, leading to complex phenotypes characterized by a functional impairment of several organs, which may lead to a considerable delay in the diagnosis. Here we review the biological and clinical features of SCIDs paying particular attention to the most recently identified forms and to their unusual or extra-immunological clinical features.

  6. Human immunodeficiency virus infection and pneumothorax

    PubMed Central

    Terzi, Eirini; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Tsiouda, Theodora; Madesis, Athanasios; Karaiskos, Theodoros

    2014-01-01

    Pneumothorax is a serious and relatively frequent complication of human immunodeficiency virus (HIV) infection that may associate with increased morbidity and mortality and may prove difficult to manage, especially in patients with acquired immunodeficiency syndrome (AIDS). PMID:25337392

  7. Experimental results from a network-assisted PID controller

    SciTech Connect

    Curtiss, P.S.

    1996-11-01

    The results presented here are a continuation of studies on a neural-network-based controller. Part 1 is a summary of the previous studies, and Part 2 presents new results and offers some novel techniques used for training the network and making the entire package easier to use. The two major additions are (1) efficient use of training data for dramatically reducing memory requirements and (2) incorporation of a PID algorithm for performing control during training periods.

  8. Tuning of PID controllers for boiler-turbine units.

    PubMed

    Tan, Wen; Liu, Jizhen; Fang, Fang; Chen, Yanqiao

    2004-10-01

    A simple two-by-two model for a boiler-turbine unit is demonstrated in this paper. The model can capture the essential dynamics of a unit. The design of a coordinated controller is discussed based on this model. A PID control structure is derived, and a tuning procedure is proposed. The examples show that the method is easy to apply and can achieve acceptable performance.

  9. Adaptive PID control based on orthogonal endocrine neural networks.

    PubMed

    Milovanović, Miroslav B; Antić, Dragan S; Milojković, Marko T; Nikolić, Saša S; Perić, Staniša Lj; Spasić, Miodrag D

    2016-12-01

    A new intelligent hybrid structure used for online tuning of a PID controller is proposed in this paper. The structure is based on two adaptive neural networks, both with built-in Chebyshev orthogonal polynomials. First substructure network is a regular orthogonal neural network with implemented artificial endocrine factor (OENN), in the form of environmental stimuli, to its weights. It is used for approximation of control signals and for processing system deviation/disturbance signals which are introduced in the form of environmental stimuli. The output values of OENN are used to calculate artificial environmental stimuli (AES), which represent required adaptation measure of a second network-orthogonal endocrine adaptive neuro-fuzzy inference system (OEANFIS). OEANFIS is used to process control, output and error signals of a system and to generate adjustable values of proportional, derivative, and integral parameters, used for online tuning of a PID controller. The developed structure is experimentally tested on a laboratory model of the 3D crane system in terms of analysing tracking performances and deviation signals (error signals) of a payload. OENN-OEANFIS performances are compared with traditional PID and 6 intelligent PID type controllers. Tracking performance comparisons (in transient and steady-state period) showed that the proposed adaptive controller possesses performances within the range of other tested controllers. The main contribution of OENN-OEANFIS structure is significant minimization of deviation signals (17%-79%) compared to other controllers. It is recommended to exploit it when dealing with a highly nonlinear system which operates in the presence of undesirable disturbances.

  10. An Attitude Control of Flexible Spacecraft Using Fuzzy-PID Controller

    NASA Astrophysics Data System (ADS)

    Park, Jong-Oh; Im, Young-Do

    This primary objective of this study is to demonstrate simulation and ground-based experiment for the attitude control of flexible spacecraft. A typical spacecraft structure consists of the rigid body and flexible appendages which are large flexible solar panels, parabolic antennas built from light materials in order to reduce their weight. Therefore the attitude control has a big problem because these appendages induce structural vibration under the excitation of external forces. A single-axis rotational simulator with a flexible arm is constructed with on-off air thrusters and reaction wheel as actuation. The simulator is also equipped with payload pointing capability by simultaneous thruster and DC servo motor actuation. The experiment of flexible spacecraft attitude control is performed using only the reaction wheel. Using the reaction wheel the performance of the fuzzy-PID controller is illustrated by simulation and experimental results for a single-axis rotational simulator.

  11. Optimal Pid Controller Design Using Adaptive Vurpso Algorithm

    NASA Astrophysics Data System (ADS)

    Zirkohi, Majid Moradi

    2015-04-01

    The purpose of this paper is to improve theVelocity Update Relaxation Particle Swarm Optimization algorithm (VURPSO). The improved algorithm is called Adaptive VURPSO (AVURPSO) algorithm. Then, an optimal design of a Proportional-Integral-Derivative (PID) controller is obtained using the AVURPSO algorithm. An adaptive momentum factor is used to regulate a trade-off between the global and the local exploration abilities in the proposed algorithm. This operation helps the system to reach the optimal solution quickly and saves the computation time. Comparisons on the optimal PID controller design confirm the superiority of AVURPSO algorithm to the optimization algorithms mentioned in this paper namely the VURPSO algorithm, the Ant Colony algorithm, and the conventional approach. Comparisons on the speed of convergence confirm that the proposed algorithm has a faster convergence in a less computation time to yield a global optimum value. The proposed AVURPSO can be used in the diverse areas of optimization problems such as industrial planning, resource allocation, scheduling, decision making, pattern recognition and machine learning. The proposed AVURPSO algorithm is efficiently used to design an optimal PID controller.

  12. Successful Handling of Disseminated BCG Disease in a Child with Severe Combined Immunodeficiency

    PubMed Central

    Bacalhau, Sílvia; Freitas, Cristina; Valente, Rosalina; Barata, Deolinda; Neves, Conceição; Schäfer, Katrin; Lubatschofski, Annelie; Schulz, Ansgar; Neves, João Farela

    2011-01-01

    In high-burden countries, Mycobacterium bovis Bacillus Calmette-Guérin (BCG) vaccine is administered in newborn to prevent severe Mycobacterium tuberculosis infection. Because life-threatening disseminated BCG disease may occur in children with primary immunodeficiency, vaccination strategy against tuberculosis should be redefined in non-high-burden countries. We report the case of a patient with X-linked severe combined immunodeficiency (SCID) who developed disseminated BCG disease, highlighting the specific strategies adopted. PMID:22110512

  13. Disseminated Bacille Calmette-Guerin (BCG) disease in an infant with severe combined immunodeficiency.

    PubMed

    Sohail, Shagufta; Afzal, Muhammad; Anwar, Vaqas; Shama, Quratulain

    2014-11-01

    Bacille Calmette-Guerin (BCG) vaccine is administered to all newborns in countries where tuberculosis is still endemic. It is a live attenuated vaccine and considered quite safe in immunocompetent children. Disseminated BCG disease is the most serious complication seen only in individuals with underlying primary or secondary immunodeficiencies. We report a case of disseminated BCG disease in an infant with Severe Combined Immunodeficiency (SCID) who received BCG administration prior to diagnosis of SCID.

  14. Human immunodeficiency virus type 1 induces cellular polarization, intercellular adhesion molecule-1 redistribution, and multinucleated giant cell generation in human primary monocytes but not in monocyte-derived macrophages.

    PubMed

    Fais, S; Borghi, P; Gherardi, G; Logozzi, M; Belardelli, F; Gessani, S

    1996-12-01

    In this study, we evaluated the effects of human immunodeficiency virus type 1 (HIV-1) on some morphologic and functional changes in cultured human monocytes/macrophages at different stages of differentiation. Freshly isolated monocytes infected with HIV-1 24 hours after seeding exhibited marked morphologic changes such as uropod formation, polarization of intercellular adhesion molecule-1 (ICAM-1) on the cytoplasmic projection, the redistribution of alpha-actinin on cell-membrane dots, and an increased release of soluble ICAM-1. These changes preceded the increase in monocyte-monocyte fusion and the formation of multinucleated giant cells. In contrast, HIV-1 infection did not affect monocyte-derived macrophages in terms of either cellular polarization or multinucleated giant cell formation. Immunocytochemistry showed that HIV-1 matrix protein was present mostly in bi- and trinucleated cells, which suggests that multinucleated giant cells may represent a long-lived and highly productive cellular source of HIV. The treatment of the HIV-1-infected monocytes with azidodeoxythymidine virtually abolished all viral-induced morphofunctional changes. On the whole, these results indicate that blood monocytes and differentiated macrophages may be affected differently by HIV infection, as monocytes seem to be much more prone to polarize, undergo homotypic fusion, and form multinucleated giant cells. These changes may confer to HIV-infected monocytes an increased ability to transmigrate through endothelia into tissues, whereas differentiated macrophages may have a predominant role as a widespread reservoir of HIV.

  15. Enteroaggregative Escherichia coli in Venda, South Africa: distribution of virulence-related genes by multiplex polymerase chain reaction in stool samples of human immunodeficiency virus (HIV)-positive and HIV-negative individuals and primary school children.

    PubMed

    Samie, Amidou; Obi, Chikwelu Larry; Dillingham, Rebecca; Pinkerton, Relana C; Guerrant, Richard L

    2007-07-01

    We used a multiplex polymerase chain reaction (PCR) and a quantitative real-time PCR to determine the distribution of three enteroaggregative Escherichia coli (EAEC) virulence-related genes in stool samples from hospital patients and school children in the Venda region of South Africa. At least one gene was found in 52 (16.5%) samples, 50 (19.6%) from hospitals and 2 (3%) from schools. The AA probe was found in 36 (69%), the aggR gene was found in 41 (79%), and the aap gene was found in 49 (94%) of all positive samples. EAEC was significantly associated with diarrhea and intestinal inflammation and was significantly higher (chi(2) = 5.360, P = 0.021) in human immunodeficiency virus (HIV)-positive persons (29.5%) than in HIV-negative persons (13.7%). The presence of EAEC genes was significantly associated with occult blood (chi(2) = 30.543, P < 0.0001) in the stool samples. This study suggests that the clinical presentation of EAEC infection may be directly related to the bacterial load as well as to the genetic characteristics of the strains involved.

  16. Bacterial Respiratory Infections Complicating Human Immunodeficiency Virus.

    PubMed

    Feldman, Charles; Anderson, Ronald

    2016-04-01

    Opportunistic bacterial and fungal infections of the lower respiratory tract, most commonly those caused by Streptococcus pneumoniae (the pneumococcus), Mycobacterium tuberculosis, and Pneumocystis jirovecii, remain the major causes of mortality in those infected with human immunodeficiency virus (HIV). Bacterial respiratory pathogens most prevalent in those infected with HIV, other than M. tuberculosis, represent the primary focus of the current review with particular emphasis on the pneumococcus, the leading cause of mortality due to HIV infection in the developed world. Additional themes include (1) risk factors; (2) the predisposing effects of HIV-mediated suppression on pulmonary host defenses, possibly intensified by smoking; (3) clinical and laboratory diagnosis, encompassing assessment of disease severity and outcome; and (4) antibiotic therapy. The final section addresses current recommendations with respect to pneumococcal immunization in the context of HIV infection, including an overview of the rationale underpinning the current "prime-boost" immunization strategy based on sequential administration of pneumococcal conjugate vaccine 13 and pneumococcal polysaccharide vaccine 23.

  17. Severe Combined Immunodeficiency (For Parents)

    MedlinePlus

    ... immune deficiency. Parents who have a child with SCID or a family history of immunodeficiency might want to consider genetic counseling ... screening for newborns. Children without a known family history of the disease are often not diagnosed until 6 months of age or ... Treating SCID SCID is a pediatric emergency. When a child ...

  18. Severe Combined Immunodeficiency (For Parents)

    MedlinePlus

    ... a doctor will test for SCID or other types of immune deficiency. Parents who have a child with SCID or a family history of immunodeficiency might want to consider genetic counseling and early blood testing, since early diagnosis can lead to prompt ...

  19. Autoimmune Cytopenias In Common Variable Immunodeficiency

    PubMed Central

    Podjasek, Jenna C.; Abraham, Roshini S.

    2012-01-01

    Common variable immunodeficiency (CVID) is a humoral immunodeficiency whose primary diagnostic features include hypogammaglobulinemia involving two or more immunoglobulin isotypes and impaired functional antibody responses in the majority of patients. While increased susceptibility to respiratory and other infections is a common thread that binds a large cross-section of CVID patients, the presence of autoimmune complications in this immunologically and clinically heterogeneous disorder is recognized in up to two-thirds of patients. Among the autoimmune manifestations reported in CVID (20–50%; Chapel et al., 2008; Cunningham-Rundles, 2008), autoimmune cytopenias are by far the most common occurring variably in 4–20% (Michel et al., 2004; Chapel et al., 2008) of these patients who have some form of autoimmunity. Association of autoimmune cytopenias with granulomatous disease and splenomegaly has been reported. The spectrum of autoimmune cytopenias includes thrombocytopenia, anemia, and neutropenia. While it may seem paradoxical “prima facie” that autoimmunity is present in patients with primary immune deficiencies, in reality, it could be considered two sides of the same coin, each reflecting a different but inter-connected facet of immune dysregulation. The expansion of CD21 low B cells in CVID patients with autoimmune cytopenias and other autoimmune features has also been previously reported. It has been demonstrated that this unique subset of B cells is enriched for autoreactive germline antibodies. Further, a correlation has been observed between various B cell subsets, such as class-switched memory B cells and plasmablasts, and autoimmunity in CVID. This review attempts to explore the most recent concepts and highlights, along with treatment of autoimmune hematological manifestations of CVID. PMID:22837758

  20. Mutation particle swarm optimization of the BP-PID controller for piezoelectric ceramics

    NASA Astrophysics Data System (ADS)

    Zheng, Huaqing; Jiang, Minlan

    2016-01-01

    PID control is the most common used method in industrial control because its structure is simple and it is easy to implement. PID controller has good control effect, now it has been widely used. However, PID method has a few limitations. The overshoot of the PID controller is very big. The adjustment time is long. When the parameters of controlled plant are changing over time, the parameters of controller could hardly change automatically to adjust to changing environment. Thus, it can't meet the demand of control quality in the process of controlling piezoelectric ceramic. In order to effectively control the piezoelectric ceramic and improve the control accuracy, this paper replaced the learning algorithm of the BP with the mutation particle swarm optimization algorithm(MPSO) on the process of the parameters setting of BP-PID. That designed a better self-adaptive controller which is combing the BP neural network based on mutation particle swarm optimization with the conventional PID control theory. This combination is called the MPSO-BP-PID. In the mechanism of the MPSO, the mutation operation is carried out with the fitness variance and the global best fitness value as the standard. That can overcome the precocious of the PSO and strengthen its global search ability. As a result, the MPSO-BP-PID can complete controlling the controlled plant with higher speed and accuracy. Therefore, the MPSO-BP-PID is applied to the piezoelectric ceramic. It can effectively overcome the hysteresis, nonlinearity of the piezoelectric ceramic. In the experiment, compared with BP-PID and PSO-BP-PID, it proved that MPSO is effective and the MPSO-BP-PID has stronger adaptability and robustness.

  1. Multi-loop decentralized PID control based on covariance control criteria: an LMI approach.

    PubMed

    Huang, Xin; Huang, Biao

    2004-01-01

    PID control is well known and widely applied in industry and many design algorithms are readily available in the literature. However, systematic design of multi-loop or decentralized PID control for multivariable processes to meet certain objectives simultaneously is still a challenging task. Designing multi-loop PID controllers such that the process variables satisfy the generalized covariance constraints is studied in this paper. A convergent computational algorithm is proposed to calculate the multi-loop PID controller for a process with stable disturbances. This algorithm is then extended to a process with random-walk disturbances. The feasibility of the proposed algorithm is verified by applying it to several simulation examples.

  2. Fuzzy Auto-adjust PID Controller Design of Brushless DC Motor

    NASA Astrophysics Data System (ADS)

    Yuanxi, Wang; Yali, Yu; Guosheng, Zhang; Xiaoliang, Sheng

    Using conventional PID control method, to guarantee the rapidity and small overshoot dynamic and static performance of the BLDCM (brushless DC motor) system is out of the question. The control method to combine fuzzy control with PID control was fit the multivariable strong coupling nonlinear characteristic of BLDCM system. Matlab/Simulink simulation model had been built. The result of computer simulation shows that, compared with the conventional PID controller, the dynamic and static performance of fuzzy auto-adjust PID controller are put forward to optimize. The research work of this paper has profound significance for high precision controller design.

  3. Simple PID parameter tuning method based on outputs of the closed loop system

    NASA Astrophysics Data System (ADS)

    Han, Jianda; Zhu, Zhiqiang; Jiang, Ziya; He, Yuqing

    2016-05-01

    Most of the existing PID parameters tuning methods are only effective with pre-known accurate system models, which often require some strict identification experiments and thus infeasible for many complicated systems. Actually, in most practical engineering applications, it is desirable for the PID tuning scheme to be directly based on the input-output response of the closed-loop system. Thus, a new parameter tuning scheme for PID controllers without explicit mathematical model is developed in this paper. The paper begins with a new frequency domain properties analysis of the PID controller. After that, the definition of characteristic frequency for the PID controller is given in order to study the mathematical relationship between the PID parameters and the open-loop frequency properties of the controlled system. Then, the concepts of M-field and θ-field are introduced, which are then used to explain how the PID control parameters influence the closed-loop frequency-magnitude property and its time responses. Subsequently, the new PID parameter tuning scheme, i.e., a group of tuning rules, is proposed based on the preceding analysis. Finally, both simulations and experiments are conducted, and the results verify the feasibility and validity of the proposed methods. This research proposes a PID parameter tuning method based on outputs of the closed loop system.

  4. An analytical method for PID controller tuning with specified gain and phase margins for integral plus time delay processes.

    PubMed

    Hu, Wuhua; Xiao, Gaoxi; Li, Xiumin

    2011-04-01

    In this paper, an analytical method is proposed for proportional-integral/proportional-derivative/proportional-integral-derivative (PI/PD/PID) controller tuning with specified gain and phase margins (GPMs) for integral plus time delay (IPTD) processes. Explicit formulas are also obtained for estimating the GPMs resulting from given PI/PD/PID controllers. The proposed method indicates a general form of the PID parameters and unifies a large number of existing rules as PI/PD/PID controller tuning with various GPM specifications. The GPMs realized by existing PID tuning rules are computed and documented as a reference for control engineers to tune the PID controllers.

  5. Simultaneous multiorgan presence of human herpesvirus 8 and restricted lymphotropism of Epstein-Barr virus DNA sequences in a human immunodeficiency virus-negative immunodeficient infant.

    PubMed

    Sánchez-Velasco, P; Ocejo-Vinyals, J G; Flores, R; Gómez-Román, J J; Lozano, M J; Leyva-Cobián, F

    2001-01-15

    Because a profound dysregulation of the immune system occurs in primary immunodeficiencies, viral infections are not uncommon. Human herpesvirus (HHV)-8 DNA was detected by polymerase chain reaction (PCR) analysis, Southern blotting, and in situ hybridization (ISH) in peripheral blood mononuclear cells and lymphoid organs (bone marrow, spleen, and lymph nodes) and endothelial and epithelial cells and macrophages from several organs (skin, lung, esophagus, intestine, choroid plexus [but not in brain or cerebellum], heart, striated muscle, liver, and kidney) of a human immunodeficiency virus-negative infant with DiGeorge anomaly who died of disseminated infection. Epstein-Barr virus DNA sequences were detected in the spleen and lymph nodes (by PCR and ISH) and in bone marrow (only by ISH) but not in blood or nonlymphoid organs. This report is believed to be the first of multiorgan dissemination of HHV-8 in a primary immunodeficiency.

  6. Stable visual PID control of a planar parallel robot

    NASA Astrophysics Data System (ADS)

    Garrido Moctezuma, Ruben; Soria López, Alberto; Trujano Cabrera, Miguel

    2008-11-01

    In this paper, we study an image-based PID control of a redundant planar parallel robot using a fixed camera configuration. The control objective is to move the robot end effector to the desired image reference position. The control law has a PD term plus an integral term with a nonlinear function of the position error. The proportional and integral actions use image loop information whereas the derivative action adds task space damping using joint level measurements. The Lyapunov method and the LaSalle invariance principle allow assessing asymptotic closed loop stability. Experiments show the feasibility of the proposed approach.

  7. Progress on Development of the New FDIRC PID Detector

    SciTech Connect

    Vavra, Jerry

    2012-08-03

    We present a progress status of a new concept of PID detector called FDIRC, intended to be used at the SuperB experiment, which requires {pi}/K separation up to a few GeV/c. The new photon camera is made of the solid fused-silica optics with a volume 25x smaller and speed increased by a factor of ten compared to the BaBar DIRC, and therefore will be much less sensitive to electromagnetic and neutron background

  8. Cytotoxic T lymphocytes specific for the simian immunodeficiency virus.

    PubMed

    Letvin, N L; Schmitz, J E; Jordan, H L; Seth, A; Hirsch, V M; Reimann, K A; Kuroda, M J

    1999-08-01

    A non-human primate model for acquired immunodeficiency syndrome (AIDS), the simian immunodeficiency virus (SIV)-infected rhesus monkey, was used to explore the role of the AIDS virus-specific cytotoxic T-lymphocyte (CTL) response in disease pathogenesis. This CTL response was measured using the major histocompatibility complex (MHC) class I/peptide tetramer technology. Large numbers of tetramer-binding CD8+ T lymphocytes were demonstrable not only in the peripheral blood, but in lymph nodes and even in semen of chronically SIV-infected monkeys. The central role of these effector T lymphocytes in containing SIV spread during primary infection was demonstrated by showing that early SIV clearance during primary infection correlated with the emergence of the tetramer binding CD8+ T lymphocytes and that in vivo depletion of CD8+ lymphocytes eliminated the ability of the infected monkeys to contain SIV replication. These observations suggest that an effective AIDS vaccine should elicit a potent virus-specific CTL response. In fact, a live, recombinant SIV vaccine constructed using the attenuated pox virus vector modified vaccinia Ankara (MVA) elicited a high-frequency CTL response, comparable in magnitude to that elicited by SIV infection itself. This suggests that vaccine modalities such as MVA may prove useful in creating an effective human immunodeficiency virus (HIV) vaccine. These studies also indicate the power of both the SIV/macaque model and MHC class I/peptide tetramers for assessing AIDS vaccine strategies.

  9. Improved automatic tuning of PID controller for stable processes.

    PubMed

    Kumar Padhy, Prabin; Majhi, Somanath

    2009-10-01

    This paper presents an improved automatic tuning method for stable processes using a modified relay in the presence of static load disturbances and measurement noise. The modified relay consists of a standard relay in series with a PI controller of unity proportional gain. The integral time constant of the PI controller of the modified relay is chosen so as to ensure a minimum loop phase margin of 30( composite function). A limit cycle is then obtained using the modified relay. Hereafter, the PID controller is designed using the limit cycle output data. The derivative time constant is obtained by maintaining the above mentioned loop phase margin. Minimizing the distance of Nyquist curve of the loop transfer function from the imaginary axis of the complex plane gives the proportional gain. The integral time constant of the PID controller is set equal to the integral time constant of the PI controller of the modified relay. The effectiveness of the proposed technique is verified by simulation results.

  10. 78 FR 29755 - Human Immunodeficiency Virus Patient-Focused Drug Development and Human Immunodeficiency Virus...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-21

    ... HUMAN SERVICES Food and Drug Administration Human Immunodeficiency Virus Patient-Focused Drug Development and Human Immunodeficiency Virus Cure Research: Public Meeting AGENCY: Food and Drug... Administration (FDA) is announcing a public meeting and an opportunity for public comment on...

  11. Study of fuzzy adaptive PID controller on thermal frequency stabilizing laser with double longitudinal modes

    NASA Astrophysics Data System (ADS)

    Mo, Qingkai; Zhang, Tao; Yan, Yining

    2016-10-01

    There are contradictions among speediness, anti-disturbance performance, and steady-state accuracy caused by traditional PID controller in the existing light source systems of thermal frequency stabilizing laser with double longitudinal modes. In this paper, a new kind of fuzzy adaptive PID controller was designed by combining fuzzy PID control technology and expert system to make frequency stabilizing system obtain the optimal performance. The experiments show that the frequency stability of the designed PID controller is similar to the existing PID controller (the magnitude of frequency stability is less than 10-9 in constant temperature and 10-7 in open air). But the preheating time is shortened obviously (from 10 minutes to 5 minutes) and the anti-disturbance capability is improved significantly (the recovery time needed after strong interference is reduced from 1 minute to 10 seconds).

  12. Design of incomplete derivative fuzzy PID control system for fast-steering mirror

    NASA Astrophysics Data System (ADS)

    Ai, Zhiwei; Tan, Yi; Wu, Qiongyan; Ren, Ge; Tan, Yufen; Zhu, Nengbing; Zhu, Fuyin

    2016-10-01

    The structure parameters of fast-steering mirror (FSM) might change with time goes by. In order to reduce the impact of this change on the output performance of FSM system, an incomplete derivative fuzzy PID control system is proposed. This control system can effectively improve the time domain quality of FSM system by optimizing the PID control parameters online. First, the dynamic model of FSM is established. Second, the initial parameters of the incomplete derivative PID control system are designed according to the frequency domain quality of the closed-loop system. Then, the rules and related factors of the fuzzy controller are designed on the basis of the initial parameters. Finally, simulation experiments are carried out. The results show that the incomplete derivative PID control system has shorter adjustment time, less overshoot and lower dependence on the parameters of FSM when compared with the fixed parameters PID control system.

  13. An improved robust fuzzy-PID controller with optimal fuzzy reasoning.

    PubMed

    Li, Han-Xiong; Zhang, Lei; Cai, Kai-Yuan; Chen, Guanrong

    2005-12-01

    Many fuzzy control schemes used in industrial practice today are based on some simplified fuzzy reasoning methods, which are simple but at the expense of losing robustness, missing fuzzy characteristics, and having inconsistent inference. The concept of optimal fuzzy reasoning is introduced in this paper to overcome these shortcomings. The main advantage is that an integration of the optimal fuzzy reasoning with a PID control structure will generate a new type of fuzzy-PID control schemes with inherent optimal-tuning features for both local optimal performance and global tracking robustness. This new fuzzy-PID controller is then analyzed quantitatively and compared with other existing fuzzy-PID control methods. Both analytical and numerical studies clearly show the improved robustness of the new fuzzy-PID controller.

  14. PID controller design for trailer suspension based on linear model

    NASA Astrophysics Data System (ADS)

    Kushairi, S.; Omar, A. R.; Schmidt, R.; Isa, A. A. Mat; Hudha, K.; Azizan, M. A.

    2015-05-01

    A quarter of an active trailer suspension system having the characteristics of a double wishbone type was modeled as a complex multi-body dynamic system in MSC.ADAMS. Due to the complexity of the model, a linearized version is considered in this paper. A model reduction technique is applied to the linear model, resulting in a reduced-order model. Based on this simplified model, a Proportional-Integral-Derivative (PID) controller was designed in MATLAB/Simulink environment; primarily to reduce excessive roll motions and thus improving the ride comfort. Simulation results show that the output signal closely imitates the input signal in multiple cases - demonstrating the effectiveness of the controller.

  15. Utilization of C-C chemokine receptor 5 by the envelope glycoproteins of a pathogenic simian immunodeficiency virus, SIVmac239.

    PubMed Central

    Marcon, L; Choe, H; Martin, K A; Farzan, M; Ponath, P D; Wu, L; Newman, W; Gerard, N; Gerard, C; Sodroski, J

    1997-01-01

    We examined chemokine receptors for the ability to facilitate the infection of CD4-expressing cells by viruses containing the envelope glycoproteins of a pathogenic simian immunodeficiency virus, SIVmac239. Expression of either human or simian C-C chemokine receptor CCR5 allowed the SIVmac239 envelope glycoproteins to mediate virus entry and cell-to-cell fusion. Thus, distantly related immunodeficiency viruses such as SIV and the primary human immunodeficiency virus type 1 isolates can utilize CCR5 as an entry cofactor. PMID:9032394

  16. Black box modeling of PIDs implemented in PLCs without structural information: a support vector regression approach.

    PubMed

    Salat, Robert; Awtoniuk, Michal

    In this report, the parameters identification of a proportional-integral-derivative (PID) algorithm implemented in a programmable logic controller (PLC) using support vector regression (SVR) is presented. This report focuses on a black box model of the PID with additional functions and modifications provided by the manufacturers and without information on the exact structure. The process of feature selection and its impact on the training and testing abilities are emphasized. The method was tested on a real PLC (Siemens and General Electric) with the implemented PID. The results show that the SVR maps the function of the PID algorithms and the modifications introduced by the manufacturer of the PLC with high accuracy. With this approach, the simulation results can be directly used to tune the PID algorithms in the PLC. The method is sufficiently universal in that it can be applied to any PI or PID algorithm implemented in the PLC with additional functions and modifications that were previously considered to be trade secrets. This method can also be an alternative for engineers who need to tune the PID and do not have any such information on the structure and cannot use the default settings for the known structures.

  17. Interval type-2 fuzzy PID controller for uncertain nonlinear inverted pendulum system.

    PubMed

    El-Bardini, Mohammad; El-Nagar, Ahmad M

    2014-05-01

    In this paper, the interval type-2 fuzzy proportional-integral-derivative controller (IT2F-PID) is proposed for controlling an inverted pendulum on a cart system with an uncertain model. The proposed controller is designed using a new method of type-reduction that we have proposed, which is called the simplified type-reduction method. The proposed IT2F-PID controller is able to handle the effect of structure uncertainties due to the structure of the interval type-2 fuzzy logic system (IT2-FLS). The results of the proposed IT2F-PID controller using a new method of type-reduction are compared with the other proposed IT2F-PID controller using the uncertainty bound method and the type-1 fuzzy PID controller (T1F-PID). The simulation and practical results show that the performance of the proposed controller is significantly improved compared with the T1F-PID controller.

  18. Modelling and Control of the Qball X4 Quadrotor System based on Pid and Fuzzy Logic Structure

    NASA Astrophysics Data System (ADS)

    Bodrumlu, Tolga; Turan Soylemez, Mehmet; Mutlu, Ilhan

    2017-01-01

    This work focuses on a quadrocopter model, which was developed by QuanserTM and named as Qball X4. First, mathematical model of the Qball X4 is obtained. Then, a conventional PID control technique is presented. This PID control parameters come from Qball user manual. After the presentation of conventional PID control, as an extension of the conventional PID control theory, a different fuzzy controller structure is given. The proposed fuzzy controller structure is based on fuzzy logic and its name is PID type fuzzy controller. All of the simulations are done in MATLABTM environment.

  19. Postnatal transmission of human immunodeficiency virus type 1: the breast-feeding dilemma.

    PubMed

    Van de Perre, P

    1995-08-01

    Human milk has been considered only recently as a source of transmission for the human immunodeficiency virus. The estimated postnatal transmission rate from mothers who acquired human immunodeficiency virus infection while lactating is 26% (95% confidence interval 13% to 39%) and may be in the range of 8% to 18% from mothers who were infected before becoming pregnant. Risk factors for postnatal transmission include maternal immune deficiency and the presence of human immunodeficiency virus-infected cells in milk. Some milk factors may be protective against postnatal transmission such as specific immunoglobulin A and immunoglobulin M and a molecule able to inhibit the binding of human immunodeficiency virus to CD4. In addition to its safety and its birth-spacing properties, breast-feeding provides immunologic protection and an ideal nutritional content to the infant. In a poor hygienic environment artificial feeding dramatically increases morbidity and mortality from diarrheal diseases and respiratory infections. Consequently, according to our current knowledge the World Health Organization and the United Nations Children's Fund reasonably recommend continuing breast-feeding promotion in women living in settings where infectious diseases and malnutrition are the primary causes of infant deaths such as in many developing countries. In settings where infectious diseases and malnutrition are not the primary causes of infant deaths, such as in most of the settings in the developed world, the advisory group recommends against breast-feeding for mothers with proved human immunodeficiency virus-1 infection.

  20. Improvement of speed control performance using PID type neurocontroller in an electric vehicle system

    SciTech Connect

    Matsumura, S.; Omatu, S.; Higasa, H.

    1994-12-31

    In order to develop an efficient driving system for electric vehicle (EV), a testing system using motors has been built to simulate the driving performance of EVs. In the testing system, the PID (Proportional Integral Derivative) controller is used to control rotating speed of motor when the EV drives. In this paper, in order to improve the performance of speed control, a neural network is applied to tuning parameters of PID controller. It is shown, through experiments that a neural network can reduce output error effectively while the PID controller parameters are being tuned online. 6 refs.

  1. Design of nonlinear PID controller and nonlinear model predictive controller for a continuous stirred tank reactor.

    PubMed

    Prakash, J; Srinivasan, K

    2009-07-01

    In this paper, the authors have represented the nonlinear system as a family of local linear state space models, local PID controllers have been designed on the basis of linear models, and the weighted sum of the output from the local PID controllers (Nonlinear PID controller) has been used to control the nonlinear process. Further, Nonlinear Model Predictive Controller using the family of local linear state space models (F-NMPC) has been developed. The effectiveness of the proposed control schemes has been demonstrated on a CSTR process, which exhibits dynamic nonlinearity.

  2. The Research of PID Control in a Large Scale Helium Refrigerator

    NASA Astrophysics Data System (ADS)

    Pan, W.; Wu, J. H.; Li, L. F.; Liu, H. M.; Li, Q.

    2015-12-01

    In the development of a helium refrigerator, the control of load temperature stability is an important requirement. We usually use multistage control strategies to achieve the precise control of it. Each level has its strict control logic. PID controllers are the core control module in the process. Therefore, a research of its principle and parameters’ setting occupies an important position in the development work. This paper detailed describes the PID control principle used in a large scale helium refrigerator of 10kW@20K, as well as several improvements on PID parameters’ setting, by using simulations and experiments in combination. The temperature is eventually controlled more precise.

  3. Variable Gain Type Internal Model Control-PID Speed Control for Ultrasonic Motors

    NASA Astrophysics Data System (ADS)

    Tanaka, Kanya; Yoshimura, Yoshie; Wakasa, Yuji; Akashi, Takuya

    Ultrasonic motors (USM) causes serious characteristic changes during operation. It is difficult for the conventional internal model control (IMC) proportional integral differential (PID) control to compensate such characteristic changes of the plant. To solve these problems, we propose a method of variable gain type IMC-PID control. In the proposed method, plant parameters are identified on line and these estimated parameters are used for adjusting three gains of PID. Then the proposed method makes it possible to compensate characteristic changes of the plant. The effectiveness of the proposed control method have been confirmed by experiments using the existing ultrasonic motors servo system.

  4. Application of adaptive PID control based on RBF-NN for the supercritical main steam

    NASA Astrophysics Data System (ADS)

    Li, Yun-Juan; Fang, Yan-jun

    2012-01-01

    The traditional PID control with RBF function the nerve network integration and made based on RBF the nerve network the PID controller. the controller for the supercritical main system, the network for temperature control system RBF an on-line to identify and build up the reference in the line and PID controller model for providing information and controllers of the online study to their control, adjust the parameter from online, the performance indicators. MATLAB simulation results show that the controller for temperature system has good control, not only keep track of good performance and robustness better.

  5. Application of adaptive PID control based on RBF-NN for the supercritical main steam

    NASA Astrophysics Data System (ADS)

    Li, Yun-Juan; Fang, Yan-Jun

    2011-12-01

    The traditional PID control with RBF function the nerve network integration and made based on RBF the nerve network the PID controller. the controller for the supercritical main system, the network for temperature control system RBF an on-line to identify and build up the reference in the line and PID controller model for providing information and controllers of the online study to their control, adjust the parameter from online, the performance indicators. MATLAB simulation results show that the controller for temperature system has good control, not only keep track of good performance and robustness better.

  6. An effective frequency domain approach to tuning non-PID controllers for high performance.

    PubMed

    Wang, Qing-Guo; Ru, He; Huang, Xiao-Gang

    2002-01-01

    In this paper, a new tuning method is proposed for the design of non-PID controllers for complex processes to achieve high performance. Compared with the existing PID tuning methods, the proposed non-PID controller design method can yield better performance for a wide range of complex processes. A suitable objective transfer function for the closed-loop system is chosen according to process characteristics. The corresponding ideal controller is derived. Model reduction is applied to fit the ideal controller into a much simpler and realizable form. Stability analysis is given and simulation examples are provided to demonstrate the effectiveness of the proposed method.

  7. Thermal response simulation for tuning PID controllers in a 1016 mm guarded hot plate apparatus.

    PubMed

    Thomas, William C; Zarr, Robert R

    2011-07-01

    A mathematical model has been developed and used to simulate the controlled thermal performance of a large guarded hot-plate apparatus. This highly specialized apparatus comprises three interdependent components whose temperatures are closely controlled in order to measure the thermal conductivity of insulation materials. The simulation model was used to investigate control strategies and derive controller gain parameters that are directly transferable to the actual instrument. The simulations take orders-of-magnitude less time to carry out when compared to traditional tuning methods based on operating the actual apparatus. The control system consists primarily of a PC-based PID control algorithm that regulates the output voltage of programmable power amplifiers. Feedback parameters in the form of controller gains are required for the three heating circuits. An objective is to determine an improved set of gains that meet temperature control criteria for testing insulation materials of interest. The analytical model is based on aggregated thermal capacity representations of the primary components and includes the same control algorithm as used in the actual hot-plate apparatus. The model, accounting for both thermal characteristics and temperature control, was validated by comparisons with test data. The tuning methodology used with the simulation model is described and results are presented. The resulting control algorithm and gain parameters have been used in the actual apparatus without modification during several years of testing materials over wide ranges of thermal conductivity, thickness, and insulation resistance values.

  8. A new multiobjective performance criterion used in PID tuning optimization algorithms

    PubMed Central

    Sahib, Mouayad A.; Ahmed, Bestoun S.

    2015-01-01

    In PID controller design, an optimization algorithm is commonly employed to search for the optimal controller parameters. The optimization algorithm is based on a specific performance criterion which is defined by an objective or cost function. To this end, different objective functions have been proposed in the literature to optimize the response of the controlled system. These functions include numerous weighted time and frequency domain variables. However, for an optimum desired response it is difficult to select the appropriate objective function or identify the best weight values required to optimize the PID controller design. This paper presents a new time domain performance criterion based on the multiobjective Pareto front solutions. The proposed objective function is tested in the PID controller design for an automatic voltage regulator system (AVR) application using particle swarm optimization algorithm. Simulation results show that the proposed performance criterion can highly improve the PID tuning optimization in comparison with traditional objective functions. PMID:26843978

  9. Method study on fuzzy-PID adaptive control of electric-hydraulic hitch system

    NASA Astrophysics Data System (ADS)

    Li, Mingsheng; Wang, Liubu; Liu, Jian; Ye, Jin

    2017-03-01

    In this paper, fuzzy-PID adaptive control method is applied to the control of tractor electric-hydraulic hitch system. According to the characteristics of the system, a fuzzy-PID adaptive controller is designed and the electric-hydraulic hitch system model is established. Traction control and position control performance simulation are carried out with the common PID control method. A field test rig was set up to test the electric-hydraulic hitch system. The test results showed that, after the fuzzy-PID adaptive control is adopted, when the tillage depth steps from 0.1m to 0.3m, the system transition process time is 4s, without overshoot, and when the tractive force steps from 3000N to 7000N, the system transition process time is 5s, the system overshoot is 25%.

  10. Fractional order PID controller for improvement of PMSM speed control in aerospace applications

    SciTech Connect

    Saraji, Ali Motalebi; Ghanbari, Mahmood

    2014-12-10

    Because of the benefits reduced size, cost and maintenance, noise, CO2 emissions and increased control flexibility and precision, to meet these expectations, electrical equipment increasingly utilize in modern aircraft systems and aerospace industry rather than conventional mechanic, hydraulic, and pneumatic power systems. Electric motor drives are capable of converting electrical power to drive actuators, pumps, compressors, and other subsystems at variable speeds. In the past decades, permanent magnet synchronous motor (PMSM) and brushless dc (BLDC) motor were investigated for aerospace applications such as aircraft actuators. In this paper, the fractional-order PID controller is used in the design of speed loop of PMSM speed control system. Having more parameters for tuning fractional order PID controller lead to good performance ratio to integer order. This good performance is shown by comparison fractional order PID controller with the conventional PI and tuned PID controller by Genetic algorithm in MATLAB soft wear.

  11. Fractional order PID controller for improvement of PMSM speed control in aerospace applications

    NASA Astrophysics Data System (ADS)

    Saraji, Ali Motalebi; Ghanbari, Mahmood

    2014-12-01

    Because of the benefits reduced size, cost and maintenance, noise, CO2 emissions and increased control flexibility and precision, to meet these expectations, electrical equipment increasingly utilize in modern aircraft systems and aerospace industry rather than conventional mechanic, hydraulic, and pneumatic power systems. Electric motor drives are capable of converting electrical power to drive actuators, pumps, compressors, and other subsystems at variable speeds. In the past decades, permanent magnet synchronous motor (PMSM) and brushless dc (BLDC) motor were investigated for aerospace applications such as aircraft actuators. In this paper, the fractional-order PID controller is used in the design of speed loop of PMSM speed control system. Having more parameters for tuning fractional order PID controller lead to good performance ratio to integer order. This good performance is shown by comparison fractional order PID controller with the conventional PI and tuned PID controller by Genetic algorithm in MATLAB soft wear.

  12. Design of sewage treatment system by applying fuzzy adaptive PID controller

    NASA Astrophysics Data System (ADS)

    Jin, Liang-Ping; Li, Hong-Chan

    2013-03-01

    In the sewage treatment system, the dissolved oxygen concentration control, due to its nonlinear, time-varying, large time delay and uncertainty, is difficult to establish the exact mathematical model. While the conventional PID controller only works with good linear not far from its operating point, it is difficult to realize the system control when the operating point far off. In order to solve the above problems, the paper proposed a method which combine fuzzy control with PID methods and designed a fuzzy adaptive PID controller based on S7-300 PLC .It employs fuzzy inference method to achieve the online tuning for PID parameters. The control algorithm by simulation and practical application show that the system has stronger robustness and better adaptability.

  13. Frequency-domain Model Matching PID Controller Design for Aero-engine

    NASA Astrophysics Data System (ADS)

    Liu, Nan; Huang, Jinquan; Lu, Feng

    2014-12-01

    The nonlinear model of aero-engine was linearized at multiple operation points by using frequency response method. The validation results indicate high accuracy of static and dynamic characteristics of the linear models. The improved PID tuning method of frequency-domain model matching was proposed with the system stability condition considered. The proposed method was applied to the design of PID controller of the high pressure rotor speed control in the flight envelope, and the control effects were evaluated by the nonlinear model. Simulation results show that the system had quick dynamic response with zero overshoot and zero steadystate error. Furthermore, a PID-fuzzy switching control scheme for aero-engine was designed, and the fuzzy switching system stability was proved. Simulations were studied to validate the applicability of the multiple PIDs fuzzy switching controller for aero-engine with wide range dynamics.

  14. Fault tolerant control of multivariable processes using auto-tuning PID controller.

    PubMed

    Yu, Ding-Li; Chang, T K; Yu, Ding-Wen

    2005-02-01

    Fault tolerant control of dynamic processes is investigated in this paper using an auto-tuning PID controller. A fault tolerant control scheme is proposed composing an auto-tuning PID controller based on an adaptive neural network model. The model is trained online using the extended Kalman filter (EKF) algorithm to learn system post-fault dynamics. Based on this model, the PID controller adjusts its parameters to compensate the effects of the faults, so that the control performance is recovered from degradation. The auto-tuning algorithm for the PID controller is derived with the Lyapunov method and therefore, the model predicted tracking error is guaranteed to converge asymptotically. The method is applied to a simulated two-input two-output continuous stirred tank reactor (CSTR) with various faults, which demonstrate the applicability of the developed scheme to industrial processes.

  15. Comparative study of a learning fuzzy PID controller and a self-tuning controller.

    PubMed

    Kazemian, H B

    2001-01-01

    The self-organising fuzzy controller is an extension of the rule-based fuzzy controller with an additional learning capability. The self-organising fuzzy (SOF) is used as a master controller to readjust conventional PID gains at the actuator level during the system operation, copying the experience of a human operator. The application of the self-organising fuzzy PID (SOF-PID) controller to a 2-link non-linear revolute-joint robot-arm is studied using path tracking trajectories at the setpoint. For the purpose of comparison, the same experiments are repeated by using the self-tuning controller subject to the same data supplied at the setpoint. For the path tracking experiments, the output trajectories of the SOF-PID controller followed the specified path closer and smoother than the self-tuning controller.

  16. A new multiobjective performance criterion used in PID tuning optimization algorithms.

    PubMed

    Sahib, Mouayad A; Ahmed, Bestoun S

    2016-01-01

    In PID controller design, an optimization algorithm is commonly employed to search for the optimal controller parameters. The optimization algorithm is based on a specific performance criterion which is defined by an objective or cost function. To this end, different objective functions have been proposed in the literature to optimize the response of the controlled system. These functions include numerous weighted time and frequency domain variables. However, for an optimum desired response it is difficult to select the appropriate objective function or identify the best weight values required to optimize the PID controller design. This paper presents a new time domain performance criterion based on the multiobjective Pareto front solutions. The proposed objective function is tested in the PID controller design for an automatic voltage regulator system (AVR) application using particle swarm optimization algorithm. Simulation results show that the proposed performance criterion can highly improve the PID tuning optimization in comparison with traditional objective functions.

  17. Auto-tuning of PID controller parameters with supervised receding horizon optimization.

    PubMed

    Xu, Min; Li, Shaoyuan; Qi, Chenkun; Cai, Wenjian

    2005-10-01

    In this paper, a novel two-layer online auto-tuning algorithm is presented for a nonlinear time-varying system. The lower layer consists of a conventional proportional-integral-derivative (PID) controller and a plant process, while the upper layer is composed of identification and tuning modules. The purpose of the upper layer is to find a set of optimal PID parameters for the lower layer via an online receding horizon optimization approach, which result in a time-varying PID controller. Through mathematical analysis, the proposed system performance is equivalent to that of a standard generalized predictive control. Simulation and experiment demonstrate that the new method has a better control system performance compared with conventional PID controllers.

  18. Nonlinear control of an activated sludge aeration process: use of fuzzy techniques for tuning PID controllers.

    PubMed

    Rodrigo, M A; Seco, A; Ferrer, J; Penya-roja, J M; Valverde, J L

    1999-01-01

    In this paper, several tuning algorithms, specifically ITAE, IMC and Cohen and Coon, were applied in order to tune an activated sludge aeration PID controller. Performance results of these controllers were compared by simulation with those obtained by using a nonlinear fuzzy PID controller. In order to design this controller, a trial and error procedure was used to determine, as a function of error at current time and at a previous time, sets of parameters (including controller gain, integral time and derivative time) which achieve satisfactory response of a PID controller actuating over the aeration process. Once these sets of data were obtained, neural networks were used to obtain fuzzy membership functions and fuzzy rules of the fuzzy PID controller.

  19. Stabilization and PID tuning algorithms for second-order unstable processes with time-delays.

    PubMed

    Seer, Qiu Han; Nandong, Jobrun

    2017-03-01

    Open-loop unstable systems with time-delays are often encountered in process industry, which are often more difficult to control than stable processes. In this paper, the stabilization by PID controller of second-order unstable processes, which can be represented as second-order deadtime with an unstable pole (SODUP) and second-order deadtime with two unstable poles (SODTUP), is performed via the necessary and sufficient criteria of Routh-Hurwitz stability analysis. The stability analysis provides improved understanding on the existence of a stabilizing range of each PID parameter. Three simple PID tuning algorithms are proposed to provide desired closed-loop performance-robustness within the stable regions of controller parameters obtained via the stability analysis. The proposed PID controllers show improved performance over those derived via some existing methods.

  20. Radial Basis Function Neural Network-based PID model for functional electrical stimulation system control.

    PubMed

    Cheng, Longlong; Zhang, Guangju; Wan, Baikun; Hao, Linlin; Qi, Hongzhi; Ming, Dong

    2009-01-01

    Functional electrical stimulation (FES) has been widely used in the area of neural engineering. It utilizes electrical current to activate nerves innervating extremities affected by paralysis. An effective combination of a traditional PID controller and a neural network, being capable of nonlinear expression and adaptive learning property, supply a more reliable approach to construct FES controller that help the paraplegia complete the action they want. A FES system tuned by Radial Basis Function (RBF) Neural Network-based Proportional-Integral-Derivative (PID) model was designed to control the knee joint according to the desired trajectory through stimulation of lower limbs muscles in this paper. Experiment result shows that the FES system with RBF Neural Network-based PID model get a better performance when tracking the preset trajectory of knee angle comparing with the system adjusted by Ziegler- Nichols tuning PID model.

  1. Antifungal prophylaxis during neutropenia and immunodeficiency.

    PubMed Central

    Lortholary, O; Dupont, B

    1997-01-01

    Fungal infections represent a major source of morbidity and mortality in patients with almost all types of immunodeficiencies. These infections may be nosocomial (aspergillosis) or community acquired (cryptococcosis), or both (candidiasis). Endemic mycoses such as histoplasmosis, coccidioidomycosis, and penicilliosis may infect many immunocompromised hosts in some geographic areas and thereby create major public health problems. With the wide availability of oral azoles, antifungal prophylactic strategies have been extensively developed. However, only a few well-designed studies involving strict criteria have been performed, mostly in patients with hematological malignancies or AIDS. In these situations, the best dose and duration of administration of the antifungal drug often remain to be determined. In high-risk neutropenic or bone marrow transplant patients, fluconazole is effective for the prevention of superficial and/or systemic candidal infections but is not always able to prolong overall survival and potentially selects less susceptible or resistant Candida spp. Primary prophylaxis against aspergillosis remains investigative. At present, no standard general recommendation for primary antifungal prophylaxis can be proposed for AIDS patients or transplant recipients. However, for persistently immunocompromised patients who previously experienced a noncandidal systemic fungal infection, prolonged suppressive antifungal therapy is often indicated to prevent a relapse. Better strategies for controlling immune deficiencies should also help to avoid some potentially life-threatening deep mycoses. When prescribing antifungal prophylaxis, physicians should be aware of the potential emergence of resistant strains, drug-drug interactions, and the cost. Well-designed, randomized, multicenter clinical trials in high-risk immunocompromised hosts are urgently needed to better define how to prevent severe invasive mycoses. PMID:9227863

  2. Pediatric human immunodeficiency virus infection.

    PubMed Central

    Domachowske, J B

    1996-01-01

    In the past decade, an increase in pediatric human immunodeficiency virus (HIV) infection has had a substantial impact on childhood morbidity and mortality worldwide. The vertical transmission of HIV from mother to infant accounts for the vast majority of these cases. Identification of HIV-infected pregnant women needs to be impoved so that appropriate therapy can be initiated for both mothers and infants. While recent data demonstrate a dramatic decrease in HIV transmission from a subset of women treated with zidovudine during pregnancy, further efforts at reducing transmission are desperately needed. This review focuses on vertically transmitted HIV infection in children, its epidemiology, diagnostic criteria, natural history, and clinical manifestations including infectious and noninfectious complications. An overview of the complex medical management of these children ensues, including the use of antiretroviral therapy. Opportunistic infection prophylaxis is reviewed, along with the important role of other supportive therapies. PMID:8894346

  3. Delayed presentation of severe combined immunodeficiency due to prolonged maternal T cell engraftment

    PubMed Central

    Al-Muhsen, Saleh Z.

    2010-01-01

    Severe combined immunodeficiency (SCID) is a primary immunodeficiency disorder with heterogenous genetic etiologies. We describe a typical case in a 9-year-old boy that was masked by a clinically functional maternal T cell engraftment leading to late presentation with Pneumocystis jiroveci pneumonia and cytomegalovirus infection, probably following exhaustion of maternally engrafted cells. Based on immunological findings, he had a T- B+SCID phenotype. This report suggests that in rare cases, engrafted maternal T cell might persist for long time leading to partial constitution of immune function and delayed clinical presentation of SCID. PMID:20427943

  4. Educational paper. The expanding clinical and immunological spectrum of severe combined immunodeficiency.

    PubMed

    van der Burg, Mirjam; Gennery, Andy R

    2011-05-01

    Severe combined immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency characterized by absence of functional T lymphocytes. It is a paediatric emergency, which is life-threatening when recognized too late. The clinical presentation varies from the classical form of SCID through atypical SCID to Omenn syndrome. In addition, there is a considerable immunological variation, which can hamper the diagnosis. In this educational review, we describe the immunopathological background, clinical presentations and diagnostic process of SCID, as well as the therapeutic possibilities.

  5. Crohn's-like disease in a patient with common variable immunodeficiency treated with azathioprine and adalimumab.

    PubMed

    Vázquez-Morón, Juan María; Pallarés-Manrique, Héctor; Martín-Suárez, Ignacio Javier; Benítez-Rodríguez, Beatriz; Ramos-Lora, Manuel

    2013-01-01

    Common variable immunodeficiency (CVID) is the most frequent primary antibody deficiency. It is characterized by recurrent bacterial infections, and occurrence of autoimmune and neoplastic diseases is also frequent; there is also a high prevalence of gastrointestinal diseases. There are reports of inflammatory bowel disease in this entity, but incidence is low (2-4 %). We present the case of a patient with common variable immunodeficiency suffering a chronic diarrhea episode and who was diagnosed with ileocaecal Crohn s-like disease after performing intestinal transit, CT abdomen and colonoscopy with biopsy. It was first treated with prednisone but on showing cortisone dependency, treatment with azathioprine and adalimumab was started, with good results.

  6. Dominant pole placement with fractional order PID controllers: D-decomposition approach.

    PubMed

    Mandić, Petar D; Šekara, Tomislav B; Lazarević, Mihailo P; Bošković, Marko

    2017-03-01

    Dominant pole placement is a useful technique designed to deal with the problem of controlling a high order or time-delay systems with low order controller such as the PID controller. This paper tries to solve this problem by using D-decomposition method. Straightforward analytic procedure makes this method extremely powerful and easy to apply. This technique is applicable to a wide range of transfer functions: with or without time-delay, rational and non-rational ones, and those describing distributed parameter systems. In order to control as many different processes as possible, a fractional order PID controller is introduced, as a generalization of classical PID controller. As a consequence, it provides additional parameters for better adjusting system performances. The design method presented in this paper tunes the parameters of PID and fractional PID controller in order to obtain good load disturbance response with a constraint on the maximum sensitivity and sensitivity to noise measurement. Good set point response is also one of the design goals of this technique. Numerous examples taken from the process industry are given, and D-decomposition approach is compared with other PID optimization methods to show its effectiveness.

  7. A Method for Precision Closed-Loop Irrigation Using a Modified PID Control Algorithm

    NASA Astrophysics Data System (ADS)

    Goodchild, Martin; Kühn, Karl; Jenkins, Malcolm; Burek, Kazimierz; Dutton, Andrew

    2016-04-01

    The benefits of closed-loop irrigation control have been demonstrated in grower trials which show the potential for improved crop yields and resource usage. Managing water use by controlling irrigation in response to soil moisture changes to meet crop water demands is a popular approach but requires knowledge of closed-loop control practice. In theory, to obtain precise closed-loop control of a system it is necessary to characterise every component in the control loop to derive the appropriate controller parameters, i.e. proportional, integral & derivative (PID) parameters in a classic PID controller. In practice this is often difficult to achieve. Empirical methods are employed to estimate the PID parameters by observing how the system performs under open-loop conditions. In this paper we present a modified PID controller, with a constrained integral function, that delivers excellent regulation of soil moisture by supplying the appropriate amount of water to meet the needs of the plant during the diurnal cycle. Furthermore, the modified PID controller responds quickly to changes in environmental conditions, including rainfall events which can result in: controller windup, under-watering and plant stress conditions. The experimental work successfully demonstrates the functionality of a constrained integral PID controller that delivers robust and precise irrigation control. Coir substrate strawberry growing trial data is also presented illustrating soil moisture control and the ability to match water deliver to solar radiation.

  8. Two modified discrete PID-based sliding mode controllers for piezoelectric actuators

    NASA Astrophysics Data System (ADS)

    Cao, Y.; Chen, X. B.

    2014-01-01

    Hysteresis is a nonlinear effect that can result in the degraded performance of piezoelectric actuators (PEAs). To counteract the effect, several control methods have been developed and reported in the literature. One promising method for compensation is the use of a proportional-integral-derivative (PID)-based sliding mode control (SMC), in which the PEA hysteresis is treated as an unknown disturbance to the PEA input. If the hysteresis can be modelled or partially modelled, the integration of the hysteresis models into the control schemes may lead to further improved performance. On this philosophy, this paper presents the development of two modified discrete PID-based sliding mode controllers (PID-SMCs) for the PEAs, namely an inversion-based PID-SMC and a disturbance-observer (DOB)-based PID-SMC, in which the PEA hysteresis is predicted or partially predicted through the use of existing models for the PEA hysteresis. Experiments were performed to verify the effectiveness of the proposed control schemes. The results were compared to those of the nominal PID-SMC. By employing the inversion hysteresis and the DOB, the PEA performance was greatly improved.

  9. Longitudinal control of aircraft dynamics based on optimization of PID parameters

    NASA Astrophysics Data System (ADS)

    Deepa, S. N.; Sudha, G.

    2016-03-01

    Recent years many flight control systems and industries are employing PID controllers to improve the dynamic behavior of the characteristics. In this paper, PID controller is developed to improve the stability and performance of general aviation aircraft system. Designing the optimum PID controller parameters for a pitch control aircraft is important in expanding the flight safety envelope. Mathematical model is developed to describe the longitudinal pitch control of an aircraft. The PID controller is designed based on the dynamic modeling of an aircraft system. Different tuning methods namely Zeigler-Nichols method (ZN), Modified Zeigler-Nichols method, Tyreus-Luyben tuning, Astrom-Hagglund tuning methods are employed. The time domain specifications of different tuning methods are compared to obtain the optimum parameters value. The results prove that PID controller tuned by Zeigler-Nichols for aircraft pitch control dynamics is better in stability and performance in all conditions. Future research work of obtaining optimum PID controller parameters using artificial intelligence techniques should be carried out.

  10. PID feedback controller used as a tactical asset allocation technique: The G.A.M. model

    NASA Astrophysics Data System (ADS)

    Gandolfi, G.; Sabatini, A.; Rossolini, M.

    2007-09-01

    The objective of this paper is to illustrate a tactical asset allocation technique utilizing the PID controller. The proportional-integral-derivative (PID) controller is widely applied in most industrial processes; it has been successfully used for over 50 years and it is used by more than 95% of the plants processes. It is a robust and easily understood algorithm that can provide excellent control performance in spite of the diverse dynamic characteristics of the process plant. In finance, the process plant, controlled by the PID controller, can be represented by financial market assets forming a portfolio. More specifically, in the present work, the plant is represented by a risk-adjusted return variable. Money and portfolio managers’ main target is to achieve a relevant risk-adjusted return in their managing activities. In literature and in the financial industry business, numerous kinds of return/risk ratios are commonly studied and used. The aim of this work is to perform a tactical asset allocation technique consisting in the optimization of risk adjusted return by means of asset allocation methodologies based on the PID model-free feedback control modeling procedure. The process plant does not need to be mathematically modeled: the PID control action lies in altering the portfolio asset weights, according to the PID algorithm and its parameters, Ziegler-and-Nichols-tuned, in order to approach the desired portfolio risk-adjusted return efficiently.

  11. A novel auto-tuning PID control mechanism for nonlinear systems.

    PubMed

    Cetin, Meric; Iplikci, Serdar

    2015-09-01

    In this paper, a novel Runge-Kutta (RK) discretization-based model-predictive auto-tuning proportional-integral-derivative controller (RK-PID) is introduced for the control of continuous-time nonlinear systems. The parameters of the PID controller are tuned using RK model of the system through prediction error-square minimization where the predicted information of tracking error provides an enhanced tuning of the parameters. Based on the model-predictive control (MPC) approach, the proposed mechanism provides necessary PID parameter adaptations while generating additive correction terms to assist the initially inadequate PID controller. Efficiency of the proposed mechanism has been tested on two experimental real-time systems: an unstable single-input single-output (SISO) nonlinear magnetic-levitation system and a nonlinear multi-input multi-output (MIMO) liquid-level system. RK-PID has been compared to standard PID, standard nonlinear MPC (NMPC), RK-MPC and conventional sliding-mode control (SMC) methods in terms of control performance, robustness, computational complexity and design issue. The proposed mechanism exhibits acceptable tuning and control performance with very small steady-state tracking errors, and provides very short settling time for parameter convergence.

  12. Performance-based parameter tuning method of model-driven PID control systems.

    PubMed

    Zhao, Y M; Xie, W F; Tu, X W

    2012-05-01

    In this paper, performance-based parameter tuning method of model-driven Two-Degree-of-Freedom PID (MD TDOF PID) control system has been proposed to enhance the control performances of a process. Known for its ability of stabilizing the unstable processes, fast tracking to the change of set points and rejecting disturbance, the MD TDOF PID has gained research interest recently. The tuning methods for the reported MD TDOF PID are based on internal model control (IMC) method instead of optimizing the performance indices. In this paper, an Integral of Time Absolute Error (ITAE) zero-position-error optimal tuning and noise effect minimizing method is proposed for tuning two parameters in MD TDOF PID control system to achieve the desired regulating and disturbance rejection performance. The comparison with Two-Degree-of-Freedom control scheme by modified smith predictor (TDOF CS MSP) and the designed MD TDOF PID tuned by the IMC tuning method demonstrates the effectiveness of the proposed tuning method.

  13. An improved auto-tuning scheme for PID controllers.

    PubMed

    Dey, Chanchal; Mudi, Rajani K

    2009-10-01

    An improved auto-tuning scheme is proposed for Ziegler-Nichols (ZN) tuned PID controllers (ZNPIDs), which usually provide excessively large overshoots, not tolerable in most of the situations, for high-order and nonlinear processes. To overcome this limitation ZNPIDs are upgraded by some easily interpretable heuristic rules through an online gain modifying factor defined on the instantaneous process states. This study is an extension of our earlier work [Mudi RK., Dey C. Lee TT. An improved auto-tuning scheme for PI controllers. ISA Trans 2008; 47: 45-52] to ZNPIDs, thereby making the scheme suitable for a wide range of processes and more generalized too. The proposed augmented ZNPID (AZNPID) is tested on various high-order linear and nonlinear dead-time processes with improved performance over ZNPID, refined ZNPID (RZNPID), and other schemes reported in the literature. Stability issues are addressed for linear processes. Robust performance of AZNPID is observed while changing its tunable parameters as well as the process dead-time. The proposed scheme is also implemented on a real time servo-based position control system.

  14. Glioblastoma multiforme of the brain stem in a patient with acquired immunodeficiency syndrome.

    PubMed

    Wolff, R; Zimmermann, M; Marquardt, Gerhard; Lanfermann, H; Nafe, R; Seifert, V

    2002-09-01

    Glioblastoma of the brain stem is rare and there is no description of such a lesion in patients suffering from acquired immunodeficiency syndrome. The majority of intracerebral mass lesions are due either to toxoplasmosis or primary central nervous system lymphomas so that it is usually not included in the differential diagnosis of enhancing lesions of the central nervous system in these patients. A 31-year-old human immunodeficiency virus (HIV) infected man presented with a four months history of slowly progressive deterioration of brainstem associated symptoms despite antitoxoplasmic therapy. Magnetic resonance imaging revealed a large ring enhancing lesion in the brainstem. Clinical and neuroradiological data could not establish a proper diagnosis and a stereotactic serial biopsy was undertaken. Histological examination of the specimen showed a glioblastoma multiforme (GBM) as the first reported case of GBM located in the brainstem in an acquired immunodeficiency syndrome (AIDS) patient. Patient management and effectiveness of stereotactic serial biopsy are discussed.

  15. Screening for Human Immunodeficiency Virus (HIV)

    MedlinePlus

    ... Task Force learned about the potential benefits and harms of this screening: (1) Everyone aged 15 to ... the disease to other people. Potential Benefits and Harms of Screening for Human Immunodeficiency Virus (HIV) The ...

  16. Inherited and acquired immunodeficiencies underlying tuberculosis in childhood

    PubMed Central

    Boisson-Dupuis, Stéphanie; Bustamante, Jacinta; El-Baghdadi, Jamila; Camcioglu, Yildiz; Parvaneh, Nima; Azbaoui, Safaa El; Agader, Aomar; Hassani, Amal; Hafidi, Naima El; Mrani, Nidal Alaoui; Jouhadi, Zineb; Ailal, Fatima; Najib, Jilali; Reisli, Ismail; Zamani, Adil; Yosunkaya, Sebnem; Gulle-Girit, Saniye; Yildiran, Alisan; Cipe, Funda Erol; Torun, Selda Hancerli; Metin, Ayse; Atikan, Basak Yildiz; Hatipoglu, Nevin; Aydogmus, Cigdem; Kilic, Sara Sebnem; Dogu, Figen; Karaca, Neslihan; Aksu, Guzide; Kutukculer, Necil; Keser-Emiroglu, Melike; Somer, Ayper; Tanir, Gonul; Aytekin, Caner; Adimi, Parisa; Mahdaviani, Seyed Alireza; Mamishi, Setareh; Bousfiha, Aziz; Sanal, Ozden; Mansouri, Davood; Casanova, Jean-Laurent; Abel, Laurent

    2015-01-01

    Summary Tuberculosis (TB), caused by Mycobacterium tuberculosis (M.tb) and a few related mycobacteria, is a devastating disease, killing more than a million individuals per year worldwide. However, its pathogenesis remains largely elusive, as only a small proportion of infected individuals develop clinical disease either during primary infection or during reactivation from latency or secondary infection. Subacute, hematogenous, and extrapulmonary disease tends to be more frequent in infants, children, and teenagers than in adults. Life-threatening primary TB of childhood can result from known acquired or inherited immunodeficiencies, although the vast majority of cases remain unexplained. We review here the conditions conferring a predisposition to childhood clinical diseases caused by mycobacteria, including not only M.tb but also weakly virulent mycobacteria, such as BCG vaccines and environmental mycobacteria. Infections with weakly virulent mycobacteria are much rarer than TB, but the inherited and acquired immunodeficiencies underlying these infections are much better known. Their study has also provided genetic and immunological insights into childhood TB, as illustrated by the discovery of single-gene inborn errors of IFN-γ immunity underlying severe cases of TB. Novel findings are expected from ongoing and future human genetic studies of childhood TB in countries that combine a high proportion of consanguineous marriages, a high incidence of TB, and an excellent clinical care, such as Iran, Morocco, and Turkey. PMID:25703555

  17. Systematic Search for Primary Immunodeficiency in Adults With Infections

    ClinicalTrials.gov

    2016-11-23

    Complement Deficiency; Antibody Deficiency; Chronic Sinus Infection; Meningitis, Bacterial; Pneumonia, Bacterial; Otitis Media; Streptococcal Infection; Neisseria Infections; Haemophilus Influenza; Pneumococcal Infections

  18. A uniform LMI formulation for tuning PID, multi-term fractional-order PID, and Tilt-Integral-Derivative (TID) for integer and fractional-order processes.

    PubMed

    Merrikh-Bayat, Farshad

    2017-03-15

    In this paper first the Multi-term Fractional-Order PID (MFOPID) whose transfer function is equal to [Formula: see text] , where kj and αj are unknown and known real parameters respectively, is introduced. Without any loss of generality, a special form of MFOPID with transfer function kp+ki/s+kd1s+kd2s(μ) where kp, ki, kd1, and kd2 are unknown real and μ is a known positive real parameter, is considered. Similar to PID and TID, MFOPID is also linear in its parameters which makes it possible to study all of them in a same framework. Tuning the parameters of PID, TID, and MFOPID based on loop shaping using Linear Matrix Inequalities (LMIs) is discussed. For this purpose separate LMIs for closed-loop stability (of sufficient type) and adjusting different aspects of the open-loop frequency response are developed. The proposed LMIs for stability are obtained based on the Nyquist stability theorem and can be applied to both integer and fractional-order (not necessarily commensurate) processes which are either stable or have one unstable pole. Numerical simulations show that the performance of the four-variable MFOPID can compete the trivial five-variable FOPID and often excels PID and TID.

  19. Design of a new PID controller using predictive functional control optimization for chamber pressure in a coke furnace.

    PubMed

    Zhang, Jianming

    2017-03-01

    An improved proportional-integral-derivative (PID) controller based on predictive functional control (PFC) is proposed and tested on the chamber pressure in an industrial coke furnace. The proposed design is motivated by the fact that PID controllers for industrial processes with time delay may not achieve the desired control performance because of the unavoidable model/plant mismatches, while model predictive control (MPC) is suitable for such situations. In this paper, PID control and PFC algorithm are combined to form a new PID controller that has the basic characteristic of PFC algorithm and at the same time, the simple structure of traditional PID controller. The proposed controller was tested in terms of set-point tracking and disturbance rejection, where the obtained results showed that the proposed controller had the better ensemble performance compared with traditional PID controllers.

  20. An update on treatment strategies for common variable immunodeficiency.

    PubMed

    Detková, Drahomíra; Español, Teresa

    2009-07-01

    Common variable immunodeficiency (CVID) is a primary immunological disease with variable severity, ranging from mild forms of infections to chronic progressive complications. The hallmark of this disorder is hypogammaglobulinemia due to an unknown molecular defect in immune regulation. The primary clinical manifestations are recurrent infections that may lead to structural damage of affected organs. Adequate intravenous immunoglobulin (Ig) therapy has dramatically changed the prognosis of this disorder, and the advent of home subcutaneous Ig therapy has further improved the quality of life of these patients. Aberrant T-cell functions predispose to autoimmune, inflammatory and lymphoproliferative complications, as well as malignancies in a variable percentage of CVID patients. Immunosuppressive anti-inflammatory therapies and chemotherapy are used, although always in conjunction with adequate replacement Ig therapy and adjunct antimicrobial prophylaxis. Any organ can be involved and therefore a multidisciplinary approach to the management of this disorder is essential.

  1. PID tuning: It`s the method, not the rules

    SciTech Connect

    St. Clair, D.W.; Fruehauf, P.S.

    1994-12-01

    Many authors have written rules for tuning controllers, providing formulas for PID settings based on the results of perturbing the process. This article is not one of those. Instead, the authors approach the subject from the other direction - focusing on the mechanics of just how you go about perturbing the process to get the numbers to use in the formulas. The basic principle of tuning is to set the time and amount parameters of the controller to fit the time and amount parameters (called dynamics) of the process. Tuning procedures show certain dynamic characteristics of the process. When tuning, it`s generally necessary to upset the process. While sophisticated, computer-based ways to learn process dynamics exist, there are two simple time-honored ways: automatic (closed-loop) and manual (open-loop). The key is to upset the process just enough to get the information you need, without getting into trouble. Before tuning a controller, you should have an idea of how fast and how far the process is going to respond to the controller output. You should know and agree on how much change you will allow in the process and in the controller output. You also should know and agree on who is going to do the actual adjusting of the controller settings, and be assured the person know how to do it. You should know, and agree on who is going to switch between manual, and automatic, and who is going to make set point or output changes. You will also need to understand the safety interlocks and any other safety concerns for the process. Record the existing settings and the controller output, in the event you want to return to them. Make sure changes are communicated to all operating people. If a log book is kept for this purpose, use it. 5 figs.

  2. Infections and immunodeficiency in bone marrow transplantation.

    PubMed

    Tutschka, P J

    1988-05-01

    After allogeneic bone marrow transplantation certain patterns of infectious complications emerge that follow the clinical course, are correlated to the immunobiology of transplantation and are almost predictable in their character and expression. The preparative regimen, designed to generate complete aplasia, will be associated with severe and sometimes life-threatening bacterial infections, predominantly with Gram-negative organisms derived from bowel flora, but also Gram-positive skin saprophytes. In this early aplastic phase, life-threatening viral infections are less common, consisting mainly of herpes simplex and possibly Epstein-Barr stomatitis and BK papovavirus cystitis. Systemic infections with invasive filamentous fungi are rare and are seen only when the induced aplasia is markedly prolonged. Once early marrow recovery has been achieved, systemic infections will generally disappear unless acute graft-vs.-host disease develops. This complication, which will lead to the breakdown of natural barriers such as skin and gastrointestinal epithelium and the marked impairment of all systemic defense mechanisms, can cause polymicrobial infections as well as set the stage for life-threatening viral infections. Such opportunistic viral infections, leading to either interstitial pneumonia or hemorrhagic gastroenteritis, are the major threat in the early recovery phase after engraftment has taken place. Usually caused by cytomegalovirus and rotavirus, respectively, these infections are the primary expression of the severe combined immunodeficiency post transplant, statistically associated with the presence of acute graft-vs.-host disease and amenable to immunologic manipulations. With the recovery of cellular and humoral immune function derived from transplanted donor lymphoid cells, the third phase of infectious complications is reached, covering 3 months to 2 years post grafting.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. 78 FR 46969 - Human Immunodeficiency Virus Patient-Focused Drug Development and Human Immunodeficiency Virus...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ... HUMAN SERVICES Food and Drug Administration Human Immunodeficiency Virus Patient-Focused Drug Development and Human Immunodeficiency Virus Cure Research; Reopening of Comment Period AGENCY: Food and Drug... Virus (HIV) Patient-Focused Drug Development and HIV Cure Research,'' published in the Federal...

  4. Radiosensitive Severe Combined Immunodeficiency Disease

    PubMed Central

    Dvorak, Christopher C.; Cowan, Morton J.

    2009-01-01

    Synopsis Inherited defects in components of the non-homologous end joining DNA repair mechanism produce a T-B-NK+ severe combined immunodeficiency disease (SCID) characterized by heightened sensitivity to ionizing radiation. Patients with the radiosensitive form of SCID may also have increased short- and long-term sensitivity to the alkylator-based chemotherapy regimens traditionally utilized for conditioning prior to allogeneic hematopoietic cell transplantation (HCT). Known etiologies of radiosensitive SCID include deficiencies of Artemis, DNA Ligase IV, DNA-dependent protein kinase catalytic subunit (DNA-PKcs), and Cernunnos-XLF, all of which have been treated with HCT. Because of their sensitivity to certain forms of chemotherapy, the approach to donor selection and type of conditioning regimen utilized for a radiosensitive SCID patient requires careful consideration. Significantly more research needs to be done in order to determine the long-term outcomes of radiosensitive SCID patients following HCT, as well as to discover novel non-toxic approaches to HCT that might benefit those with intrinsic radio- and chemo-sensitivity, as well as potentially all patients undergoing an HCT. PMID:20113890

  5. Anti-windup adaptive PID control design for a class of uncertain chaotic systems with input saturation.

    PubMed

    Tahoun, A H

    2017-01-01

    In this paper, the stabilization problem of actuators saturation in uncertain chaotic systems is investigated via an adaptive PID control method. The PID control parameters are auto-tuned adaptively via adaptive control laws. A multi-level augmented error is designed to account for the extra terms appearing due to the use of PID and saturation. The proposed control technique uses both the state-feedback and the output-feedback methodologies. Based on Lyapunov׳s stability theory, new anti-windup adaptive controllers are proposed. Demonstrative examples with MATLAB simulations are studied. The simulation results show the efficiency of the proposed adaptive PID controllers.

  6. Tuning of an optimal fuzzy PID controller with stochastic algorithms for networked control systems with random time delay.

    PubMed

    Pan, Indranil; Das, Saptarshi; Gupta, Amitava

    2011-01-01

    An optimal PID and an optimal fuzzy PID have been tuned by minimizing the Integral of Time multiplied Absolute Error (ITAE) and squared controller output for a networked control system (NCS). The tuning is attempted for a higher order and a time delay system using two stochastic algorithms viz. the Genetic Algorithm (GA) and two variants of Particle Swarm Optimization (PSO) and the closed loop performances are compared. The paper shows that random variation in network delay can be handled efficiently with fuzzy logic based PID controllers over conventional PID controllers.

  7. Progressive intracranial fusiform aneurysms and T-cell immunodeficiency.

    PubMed

    Piantino, Juan A; Goldenberg, Fernando D; Pytel, Peter; Wagner-Weiner, Linda; Ansari, Sameer A

    2013-02-01

    In the pediatric population, intracranial fusiform aneurysms have been associated with human immunodeficiency virus/acquired immunodeficiency syndrome and rarely with opportunistic infections related to other immunodeficiencies. The HIV virus and other infectious organisms have been implicated in the pathophysiology of these aneurysms. We present a child with T-cell immunodeficiency but no evidence of human immunodeficiency virus or opportunistic intracranial infections that developed progressive bilateral fusiform intracranial aneurysms. Our findings suggest a role of immunodeficiency or inflammation in the formation of some intracranial aneurysms.

  8. Design PID controllers for desired time-domain or frequency-domain response.

    PubMed

    Zhang, Weidong; Xi, Yugeng; Yang, Genke; Xu, Xiaoming

    2002-10-01

    Practical requirements on the design of control systems, especially process control systems, are usually specified in terms of time-domain response, such as overshoot and rise time, or frequency-domain response, such as resonance peak and stability margin. Although numerous methods have been developed for the design of the proportional-integral-derivative (PID) controller, little work has been done in relation to the quantitative time-domain and frequency-domain responses. In this paper, we study the following problem: Given a nominal stable process with time delay, we design a suboptimal PID controller to achieve the required time-domain response or frequency-domain response for the nominal system or the uncertain system. An H(infinity) PID controller is developed based on optimal control theory and the parameters are derived analytically. Its properties are investigated and compared with that of two developed suboptimal controllers: an H2 PID controller and a Maclaurin PID controller. It is shown that all three controllers can provide the quantitative time-domain and frequency-domain responses.

  9. Relay feedback tuning of robust PID controllers with iso-damping property.

    PubMed

    Chen, YangQuan; Moore, Kevin L

    2005-02-01

    A new tuning method for proportional-integral-derivative (PID) controller design is proposed for a class of unknown, stable, and minimum phase plants. We are able to design a PID controller to ensure that the phase Bode plot is flat, i.e., the phase derivative w.r.t. the frequency is zero, at a given frequency called the "tangent frequency" so that the closed-loop system is robust to gain variations and the step responses exhibit an iso-damping property. At the "tangent frequency," the Nyquist curve tangentially touches the sensitivity circle. Several relay feedback tests are used to identify the plant gain and phase at the tangent frequency in an iterative way. The identified plant gain and phase at the desired tangent frequency are used to estimate the derivatives of amplitude and phase of the plant with respect to frequency at the same frequency point by Bode's integral relationship. Then, these derivatives are used to design a PID controller for slope adjustment of the Nyquist plot to achieve the robustness of the system to gain variations. No plant model is assumed during the PID controller design. Only several relay tests are needed. Simulation examples illustrate the effectiveness and the simplicity of the proposed method for robust PID controller design with an iso-damping property.

  10. A fuzzy model based adaptive PID controller design for nonlinear and uncertain processes.

    PubMed

    Savran, Aydogan; Kahraman, Gokalp

    2014-03-01

    We develop a novel adaptive tuning method for classical proportional-integral-derivative (PID) controller to control nonlinear processes to adjust PID gains, a problem which is very difficult to overcome in the classical PID controllers. By incorporating classical PID control, which is well-known in industry, to the control of nonlinear processes, we introduce a method which can readily be used by the industry. In this method, controller design does not require a first principal model of the process which is usually very difficult to obtain. Instead, it depends on a fuzzy process model which is constructed from the measured input-output data of the process. A soft limiter is used to impose industrial limits on the control input. The performance of the system is successfully tested on the bioreactor, a highly nonlinear process involving instabilities. Several tests showed the method's success in tracking, robustness to noise, and adaptation properties. We as well compared our system's performance to those of a plant with altered parameters with measurement noise, and obtained less ringing and better tracking. To conclude, we present a novel adaptive control method that is built upon the well-known PID architecture that successfully controls highly nonlinear industrial processes, even under conditions such as strong parameter variations, noise, and instabilities.

  11. Improving disturbance rejection of PID controllers by means of the magnitude optimum method.

    PubMed

    Vrancić, Damir; Strmcnik, Stanko; Kocijan, Jus; de Moura Oliveira, P B

    2010-01-01

    The magnitude optimum (MO) method provides a relatively fast and non-oscillatory closed-loop tracking response for a large class of process models frequently encountered in the process and chemical industries. However, the deficiency of the method is poor disturbance rejection performance of some processes. In this paper, disturbance rejection performance of the PID controller is improved by applying the "disturbance rejection magnitude optimum" (DRMO) optimisation method, while the tracking performance has been improved by a set-point weighting and set-point filtering PID controller structure. The DRMO tuning method requires numerical optimisation for the calculation of PID controller parameters. The method was applied to two different 2-degrees-of-freedom PID controllers and has been tested on several different representatives of process models and one laboratory set-up. A comparison with some other tuning methods has shown that the proposed tuning method, with a set-point filtering PID controller, is quite efficient in improving disturbance rejection performance, while retaining tracking performance comparable with the original MO method.

  12. Intelligent algorithm tuning PID method of function electrical stimulation using knee joint angle.

    PubMed

    Qiu, Shuang; He, Feng; Tang, Jiabei; Xu, Jiapeng; Zhang, Lixin; Zhao, Xin; Qi, Hongzhi; Zhou, Peng; Cheng, Xiaoman; Wan, Baikun; Ming, Dong

    2014-01-01

    Functional electrical stimulation (FES) could restore motor functions for individuals with spinal cord injury (SCI). By applying electric current pulses, FES system could produce muscle contractions, generate joint torques, and thus, achieve joint movements automatically. Since the muscle system is highly nonlinear and time-varying, feedback control is quite necessary for precision control of the preset action. In the present study, we applied two methods (Proportional Integral Derivative (PID) controller based on Back Propagation (BP) neural network and that based on Genetic Algorithm (GA)), to control the knee joint angle for the FES system, while the traditional Ziegler-Nichols method was used in the control group for comparison. They were tested using a muscle model of the quadriceps. The results showed that intelligent algorithm tuning PID controller displayed superior performance than classic Ziegler-Nichols method with constant parameters. More particularly, PID controller tuned by BP neural network was superior on controlling precision to make the feedback signal track the desired trajectory whose error was less than 1.2°±0.16°, while GA-PID controller, seeking the optimal parameters from multipoint simultaneity, resulted in shortened delay in the response. Both strategies showed promise in application of intelligent algorithm tuning PID methods in FES system.

  13. Aspects épidémiologiques du suicide à Dakar

    PubMed Central

    Soumah, Mohamed Maniboliot; Eboué, Brice Angwé; Ndiaye, Mor; Sow, Mamadou Lamine

    2013-01-01

    Introduction Le suicidé est le sujet mort par suicide et le suicidant est la personne ayant fait des tentatives de suicide. L'objectif de cette étude porte sur l'analyse épidémiologique des suicides dans la région de Dakar. Méthodes Par une étude rétrospective portant sur les registres du service d'anatomie pathologique de l'Hôpital Aristide Le Dantec, nous rapportons 143 suicides sur 10 ans. Le traitement et l'analyse des données ont été faits sur Epidata version 2.1 b pour la saisie et Epiinfo version 6.04 fr pour l'analyse. Résultats A Dakar, les morts par suicide restent peu fréquentes au regard de la mortalité générale. Les hommes se suicident deux fois plus que les femmes et le suicide reste l'apanage de l'adulte jeune dont l'âge se situe entre 21 et 30 ans. Les suicidés résident le plus souvent en zone périurbaine et ils commettent cet acte dans la majorité des cas en période de froid (pendant les mois de janvier, février et mars), plus avant midi et en soirée qu'en après-midi. Aussi 97.2% des suicidés ont utilisé un seul moyen pour se suicider et le suicide complexe (utilisation de plusieurs moyens) a concerné seulement un cas dans notre étude. La pendaison reste le mode le plus utilisé. Conclusion Les hommes préfèrent donc des moyens de suicides violents (pendaison, arme à feu et arme blanche) alors que les femmes et les adolescents (tout sexe confondu) utilisent les intoxications. Le recueil des facteurs concourant au suicide permettrait une prévention de ce dernier. PMID:23847707

  14. A frequency response model matching method for PID controller design for processes with dead-time.

    PubMed

    Anwar, Md Nishat; Pan, Somnath

    2015-03-01

    In this paper, a PID controller design method for the integrating processes based on frequency response matching is presented. Two approaches are proposed for the controller design. In the first approach, a double feedback loop configuration is considered where the inner loop is designed with a stabilizing gain. In the outer loop, the parameters of the PID controller are obtained by frequency response matching between the closed-loop system with the PID controller and a reference model with desired specifications. In the second approach, the design is directly carried out considering a desired load-disturbance rejection model of the system. In both the approaches, two low frequency points are considered for matching the frequency response, which yield linear algebraic equations, solution of which gives the controller parameters. Several examples are taken from the literature to demonstrate the effectiveness and to compare with some well known design methods.

  15. Optimal Pid Tuning for Power System Stabilizers Using Adaptive Particle Swarm Optimization Technique

    NASA Astrophysics Data System (ADS)

    Oonsivilai, Anant; Marungsri, Boonruang

    2008-10-01

    An application of the intelligent search technique to find optimal parameters of power system stabilizer (PSS) considering proportional-integral-derivative controller (PID) for a single-machine infinite-bus system is presented. Also, an efficient intelligent search technique, adaptive particle swarm optimization (APSO), is engaged to express usefulness of the intelligent search techniques in tuning of the PID—PSS parameters. Improve damping frequency of system is optimized by minimizing an objective function with adaptive particle swarm optimization. At the same operating point, the PID—PSS parameters are also tuned by the Ziegler-Nichols method. The performance of proposed controller compared to the conventional Ziegler-Nichols PID tuning controller. The results reveal superior effectiveness of the proposed APSO based PID controller.

  16. Study on adaptive PID algorithm of hydraulic turbine governing system based on fuzzy neural network

    NASA Astrophysics Data System (ADS)

    Tang, Liangbao; Bao, Jumin

    2006-11-01

    The conventional hydraulic turbine governing system can't automatically modulate PID parameters according to the dynamic process of the system, the generator speed is unstable and the mains frequency fluctuation results in. To solve the above problem, the fuzzy neural network (FNN) and the adaptive control are combined to design an adaptive PID algorithm based on the fuzzy neural network which can effectively control the hydraulic turbine governing system. Finally, the improved mathematic model is simulated. The simulation results are compared with the conventional hydraulic turbine's. Thus the validity and superiority of the fuzzy neural network PID algorithm have been proved. The simulation results show that the algorithm not only retains the functions of fuzzy control, but also provides the ability to approach to the non-linear system. Also the dynamic process of the system can be reflected more precisely and the on-line adaptive control is implemented. The algorithm is superior to other methods in response and control effect.

  17. Nonlinear adaptive PID control for greenhouse environment based on RBF network.

    PubMed

    Zeng, Songwei; Hu, Haigen; Xu, Lihong; Li, Guanghui

    2012-01-01

    This paper presents a hybrid control strategy, combining Radial Basis Function (RBF) network with conventional proportional, integral, and derivative (PID) controllers, for the greenhouse climate control. A model of nonlinear conservation laws of enthalpy and matter between numerous system variables affecting the greenhouse climate is formulated. RBF network is used to tune and identify all PID gain parameters online and adaptively. The presented Neuro-PID control scheme is validated through simulations of set-point tracking and disturbance rejection. We compare the proposed adaptive online tuning method with the offline tuning scheme that employs Genetic Algorithm (GA) to search the optimal gain parameters. The results show that the proposed strategy has good adaptability, strong robustness and real-time performance while achieving satisfactory control performance for the complex and nonlinear greenhouse climate control system, and it may provide a valuable reference to formulate environmental control strategies for actual application in greenhouse production.

  18. Adaptive PID formation control of nonholonomic robots without leader's velocity information.

    PubMed

    Shen, Dongbin; Sun, Weijie; Sun, Zhendong

    2014-03-01

    This paper proposes an adaptive proportional integral derivative (PID) algorithm to solve a formation control problem in the leader-follower framework where the leader robot's velocities are unknown for the follower robots. The main idea is first to design some proper ideal control law for the formation system to obtain a required performance, and then to propose the adaptive PID methodology to approach the ideal controller. As a result, the formation is achieved with much more enhanced robust formation performance. The stability of the closed-loop system is theoretically proved by Lyapunov method. Both numerical simulations and physical vehicle experiments are presented to verify the effectiveness of the proposed adaptive PID algorithm.

  19. Calculation of PID controller parameters by using a fuzzy neural network.

    PubMed

    Lee, Ching-Hung; Teng, Ching-Cheng

    2003-07-01

    In this paper, we use the fuzzy neural network (FNN) to develop a formula for designing the proportional-integral-derivative (PID) controller. This PID controller satisfies the criteria of minimum integrated absolute error (IAE) and maximum of sensitivity (Ms). The FNN system is used to identify the relationship between plant model and controller parameters based on IAE and Ms. To derive the tuning rule, the dominant pole assignment method is applied to simplify our optimization processes. Therefore, the FNN system is used to automatically tune the PID controller for different system parameters so that neither theoretical methods nor numerical methods need be used. Moreover, the FNN-based formula can modify the controller to meet our specification when the system model changes. A simulation result for applying to the motor position control problem is given to demonstrate the effectiveness of our approach.

  20. PID controller auto-tuning based on process step response and damping optimum criterion.

    PubMed

    Pavković, Danijel; Polak, Siniša; Zorc, Davor

    2014-01-01

    This paper presents a novel method of PID controller tuning suitable for higher-order aperiodic processes and aimed at step response-based auto-tuning applications. The PID controller tuning is based on the identification of so-called n-th order lag (PTn) process model and application of damping optimum criterion, thus facilitating straightforward algebraic rules for the adjustment of both the closed-loop response speed and damping. The PTn model identification is based on the process step response, wherein the PTn model parameters are evaluated in a novel manner from the process step response equivalent dead-time and lag time constant. The effectiveness of the proposed PTn model parameter estimation procedure and the related damping optimum-based PID controller auto-tuning have been verified by means of extensive computer simulations.

  1. Performance assessment of PID and IMC tuning methods for a mixing process with time delay.

    PubMed

    Selvi, J Arputha Vijaya; Radhakrishnan, T K; Sundaram, S

    2007-06-01

    A flow process with time delay has been considered for modeling and control. A dilute solution of sodium chloride is used as tracer and an online conductivity measurement unit as sensor and recorder. The objective of the current study is to design control algorithms and present corresponding robust control analysis for the process. The control methodologies considered are (i) conventional PID control and (ii) internal model control (IMC). The control structures are comparatively analyzed using standard robustness measures for stability and performance. Of the two control algorithms, conventional PID and IMC, IMC exhibits faster settling time, no overshoot, better set-point tracking and disturbance rejection, and good robust performance than the PID control scheme.

  2. New tuning conditions for a class of nonlinear PID global regulators of robot manipulators

    NASA Astrophysics Data System (ADS)

    Orrante-Sakanassi, Jorge; Santibánez, Victor; Hernández-Guzmán, Victor M.

    2014-04-01

    Several nonlinear proportional-integral-derivative (PID) controllers for robot manipulators that ensure global asymptotic stability have been proposed in the literature. However, the tuning criteria obtained are expressed in terms of conditions so restrictive that they have avoided, until now, carrying out experimental tests with such controllers. Tuning criteria of some PID controllers for robot manipulators with conditions more relaxed than those presented previously in the literature have been proposed in two recent works by the authors. This was achieved by setting the tuning conditions individually for each joint instead of general conditions for the whole robot. In this paper we extend these results to a class of nonlinear PID global regulators for robot manipulators. The obtained tuning criteria are given in terms of conditions so relaxed that they have allowed to carry out, for the first time, experimental essays with these controllers. Such experiments are presented in this paper using a two-degrees-of-freedom robot manipulator.

  3. Design of PID controllers in double feedback loops for SISO systems with set-point filters.

    PubMed

    Vijayan, V; Panda, Rames C

    2012-07-01

    A PID controller is widely used to control industrial processes that are mostly open loop stable or unstable. Selection of proper feedback structure and controller tuning helps to improve the performance of the loop. In this paper a double-feedback loop/method is used to achieve stability and better performance of the process. The internal feedback is used for stabilizing the process and the outer loop is used for good setpoint tracking. An internal model controller (IMC) based PID method is used for tuning the outer loop controller. Autotuning based on relay feedback or the Ziegler-Nichols method can be used for tuning an inner loop controller. A tuning parameter (λ) that is used to tune IMC-PID is used as a time constant of a setpoint filter that is used for reducing the peak overshoot. The method has been tested successfully on many low order processes.

  4. PID self tuning control based on Mamdani fuzzy logic control for quadrotor stabilization

    SciTech Connect

    Priyambodo, Tri Kuntoro Putra, Agfianto Eko; Dharmawan, Andi

    2016-02-01

    Quadrotor as one type of UAV have the ability to perform Vertical Take Off and Landing (VTOL). It allows the Quadrotor to be stationary hovering in the air. PID (Proportional Integral Derivative) control system is one of the control methods that are commonly used. It is usually used to optimize the Quadrotor stabilization at least based on the three Eulerian angles (roll, pitch, and yaw) as input parameters for the control system. The three constants of PID can be obtained in various methods. The simplest method is tuning manually. This method has several weaknesses. For example if the three constants are not exact, the resulting response will deviate from the desired result. By combining the methods of PID with fuzzy logic systems where human expertise is implemented into the machine language is expected to further optimize the control system.

  5. TH17 Cells in Autoimmunity and Immunodeficiency: Protective or Pathogenic?

    PubMed

    Marwaha, Ashish K; Leung, Nicole J; McMurchy, Alicia N; Levings, Megan K

    2012-01-01

    In 2005 a newly discovered T helper cell subset that secreted interleukin (IL)-17 became the center of attention in immunology. Initial studies painted Th17 cells as the culprit for destruction in many different autoimmune and auto-inflammatory diseases. Subsequently, the discovery of patients with primary immunodeficiencies in the IL-17 pathway taught us that Th17 cells have a critical role in defense against certain fungal and bacterial infections. Moreover, the paradoxical exacerbation of Crohn's disease in the clinical trials of a Secukinumab (AIN457), a fully human neutralizing antibody to IL-17A, has cast into doubt a universal pro-inflammatory and harmful role for Th17 cells. Evidence now suggests that depending on the environment Th17 cells can alter their differentiation program, ultimately giving rise to either protective or pro-inflammatory cells. In this review we will summarize the evidence from patients with immunodeficiencies, autoimmune, or auto-inflammatory diseases that teaches us how the pro-inflammatory versus protective function of Th17 cells varies within the context of different human diseases.

  6. Common Variable Immunodeficiency as the initial presentation of Dyskeratosis Congenita

    PubMed Central

    Allenspach, Eric J.; Bellodi, Cristian; Jeong, David; Kopmar, Noam; Nakamura, Tomoka; Ochs, Hans D.; Ruggero, Davide; Skoda-Smith, Suzanne; Shimamura, Akiko; Torgerson, Troy R.

    2013-01-01

    Short Summary We present a case highlighting the clinical overlap between Common Variable Immunodeficiency (CVID) and Dyskeratosis Congenita (DC). It demonstrates that DC may initially present as an isolated humoral immunodeficiency resembling CVID. PMID:23403051

  7. Neural Network-Based Self-Tuning PID Control for Underwater Vehicles

    PubMed Central

    Hernández-Alvarado, Rodrigo; García-Valdovinos, Luis Govinda; Salgado-Jiménez, Tomás; Gómez-Espinosa, Alfonso; Fonseca-Navarro, Fernando

    2016-01-01

    For decades, PID (Proportional + Integral + Derivative)-like controllers have been successfully used in academia and industry for many kinds of plants. This is thanks to its simplicity and suitable performance in linear or linearized plants, and under certain conditions, in nonlinear ones. A number of PID controller gains tuning approaches have been proposed in the literature in the last decades; most of them off-line techniques. However, in those cases wherein plants are subject to continuous parametric changes or external disturbances, online gains tuning is a desirable choice. This is the case of modular underwater ROVs (Remotely Operated Vehicles) where parameters (weight, buoyancy, added mass, among others) change according to the tool it is fitted with. In practice, some amount of time is dedicated to tune the PID gains of a ROV. Once the best set of gains has been achieved the ROV is ready to work. However, when the vehicle changes its tool or it is subject to ocean currents, its performance deteriorates since the fixed set of gains is no longer valid for the new conditions. Thus, an online PID gains tuning algorithm should be implemented to overcome this problem. In this paper, an auto-tune PID-like controller based on Neural Networks (NN) is proposed. The NN plays the role of automatically estimating the suitable set of PID gains that achieves stability of the system. The NN adjusts online the controller gains that attain the smaller position tracking error. Simulation results are given considering an underactuated 6 DOF (degrees of freedom) underwater ROV. Real time experiments on an underactuated mini ROV are conducted to show the effectiveness of the proposed scheme. PMID:27608018

  8. Adaptive fuzzy PID temperature control system based on single-chip computer for the autoclave

    NASA Astrophysics Data System (ADS)

    Zhang, F.; Wang, J.; Fu, S. L.; He, Z. T.; Li, X. P.

    2008-12-01

    The autoclave is one of main preparation equipments of crystal preparation by hydrothermal method. The preparation temperature will seriously influence crystals quality and crystals size at high temperature, how to measure and control precisely the autoclave temperature can be of real significance. The characteristic of hysteresis, nonlinearity and difficulty to acquire the precise mathematical model existing in the temperature control of the autoclave was researched. The general PID controller adopted usually in the autoclave temperature control system is hard to improve temperature control performance. Based on the advantages of fuzzy controller that does not depend on the precise mathematical model and the stabilization of PID controller, single-chip computer integrated fuzzy PID control algorithm is adopted, and the temperature system is designed, the foundational working principle was discussed. The control system includes SCM (AT89C52), temperature sensor, A/D converter circuit and corresponding circuit and interface, can make the autoclave temperature measure and control accurately. The system hardware includes main circuit, thyristor drive circuit, audible and visual alarm circuit, watchdog circuit, clock circuit, keyboard and display circuit so on, which can achieve gathering, analyzing, comparing and controlling the autoclave temperature parameter. The program of control system includes the treatment and collection of temperature data, the dynamic display program, the fuzzy PID control system, the audible and visual alarm program, et al, and the system's main software, which includes initialization, key-press processing, input processing, display, and the fuzzy PID control program was analyzed. The results showed that the fuzzy PID control system makes the adjustment time of temperature decreased and the precision of temperature control improved, the quality and the crystals size of the preparation crystals can achieve the expect experiment results.

  9. Neural Network-Based Self-Tuning PID Control for Underwater Vehicles.

    PubMed

    Hernández-Alvarado, Rodrigo; García-Valdovinos, Luis Govinda; Salgado-Jiménez, Tomás; Gómez-Espinosa, Alfonso; Fonseca-Navarro, Fernando

    2016-09-05

    For decades, PID (Proportional + Integral + Derivative)-like controllers have been successfully used in academia and industry for many kinds of plants. This is thanks to its simplicity and suitable performance in linear or linearized plants, and under certain conditions, in nonlinear ones. A number of PID controller gains tuning approaches have been proposed in the literature in the last decades; most of them off-line techniques. However, in those cases wherein plants are subject to continuous parametric changes or external disturbances, online gains tuning is a desirable choice. This is the case of modular underwater ROVs (Remotely Operated Vehicles) where parameters (weight, buoyancy, added mass, among others) change according to the tool it is fitted with. In practice, some amount of time is dedicated to tune the PID gains of a ROV. Once the best set of gains has been achieved the ROV is ready to work. However, when the vehicle changes its tool or it is subject to ocean currents, its performance deteriorates since the fixed set of gains is no longer valid for the new conditions. Thus, an online PID gains tuning algorithm should be implemented to overcome this problem. In this paper, an auto-tune PID-like controller based on Neural Networks (NN) is proposed. The NN plays the role of automatically estimating the suitable set of PID gains that achieves stability of the system. The NN adjusts online the controller gains that attain the smaller position tracking error. Simulation results are given considering an underactuated 6 DOF (degrees of freedom) underwater ROV. Real time experiments on an underactuated mini ROV are conducted to show the effectiveness of the proposed scheme.

  10. Performances of PID and Different Fuzzy Methods for Controlling a Ball on Beam

    NASA Astrophysics Data System (ADS)

    Minh, Vu Trieu; Mart, Tamre; Moezzi, Reza; Oliver, Mets; Martin, Jurise; Ahti, Polder; Leo, Teder; Mart, Juurma

    2016-05-01

    This paper develops and analyses the performances evaluation of different control strategies applied for a nonlinear motion of a ball on a beam system. Comparison results provide in-depth comprehension on the stable ability of different controllers for this real mechanical application. The three different controllers are a conventional PID method, a Mamdani-type fuzzy rule method and a Sugeno-type fuzzy rule method. In this study, the PID shows the fastest sinuous reference tracking while the Mamdani-type fuzzy method proves the highest stability performance for tracking square wave motions.

  11. A PID de-tuned method for multivariable systems, applied for HVAC plant

    NASA Astrophysics Data System (ADS)

    Ghazali, A. B.

    2015-09-01

    A simple yet effective de-tuning of PID parameters for multivariable applications has been described. Although the method is felt to have wider application it is simulated in a 3-input/ 2-output building energy management system (BEMS) with known plant dynamics. The controller performances such as the sum output squared error and total energy consumption when the system is at steady state conditions are studied. This tuning methodology can also be extended to reduce the number of PID controllers as well as the control inputs for specified output references that are necessary for effective results, i.e. with good regulation performances being maintained.

  12. Continuous Firefly Algorithm for Optimal Tuning of Pid Controller in Avr System

    NASA Astrophysics Data System (ADS)

    Bendjeghaba, Omar

    2014-01-01

    This paper presents a tuning approach based on Continuous firefly algorithm (CFA) to obtain the proportional-integral- derivative (PID) controller parameters in Automatic Voltage Regulator system (AVR). In the tuning processes the CFA is iterated to reach the optimal or the near optimal of PID controller parameters when the main goal is to improve the AVR step response characteristics. Conducted simulations show the effectiveness and the efficiency of the proposed approach. Furthermore the proposed approach can improve the dynamic of the AVR system. Compared with particle swarm optimization (PSO), the new CFA tuning method has better control system performance in terms of time domain specifications and set-point tracking.

  13. Tuning PID controllers for higher-order oscillatory systems with improved performance.

    PubMed

    Malwatkar, G M; Sonawane, S H; Waghmare, L M

    2009-07-01

    In this paper, model based design of PID controllers is proposed for higher-order oscillatory systems. The proposed method has no limitations regarding systems order, time delays and oscillatory behavior. The reduced model is achieved based on third-order modeling and selection of coefficients through the use of frequency responses. The tuning of the PID parameters are obtained from a reduced third-order model; the procedure seems to be simple and effective, and improved performance of the overall system can be achieved. Three simulation examples and one real-time experiment are included to demonstrate the effectiveness and applicability of the proposed method to systems with oscillatory behavior.

  14. Oral Manifestations of Human Immunodeficiency Virus Infection

    PubMed Central

    Epstein, Joel B.; Mathias, Richard G.

    1988-01-01

    The AIDS epidemic continues. All health-care workers, including physicians and dental personnel, may be instrumental in recognizing risk factors associated with Acquired Immunodeficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) infection. Oral signs and symptoms of HIV infection may be the first presentation of the disease or may develop during the course of the disease and require management. Knowledge of the signs, symptoms and associated infections and tumours is needed to assist in recognition, diagnosis, and treatment. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 12Figure 13 PMID:21253078

  15. Intelligent self-tuning of PID control for the robotic testing system for human musculoskeletal joints test.

    PubMed

    Tian, Lianfang

    2004-06-01

    In this paper, an intelligent proportional-integral-derivative (PID) control method is introduced to the robotic testing system for the biomechanical study of human musculoskeletal joints. For the testing system, the robot is a highly nonlinear and heavily coupled complicated system, and the human spinal specimen also demonstrates nonlinear property when undergoing testing. Although the conventional PID control approach is extensively used in most industrial control systems, it will break down for nonlinear systems, particularly for complicated systems that have no precise mathematical models. To overcome those difficulties, an intelligent fuzzy PID controller is proposed replacing the widely used conventional PID controllers. The fuzzy PID algorithm is outlined using the fuzzy set theory. The design techniques are developed based on the linguistic phase plane approach. The heuristic rules of syntheses are summarized into a rule-based expert system. Experiments are carried out and the results demonstrate the good performance of the robotic testing system using the proposed control method.

  16. Application of multi-objective controller to optimal tuning of PID gains for a hydraulic turbine regulating system using adaptive grid particle swam optimization.

    PubMed

    Chen, Zhihuan; Yuan, Yanbin; Yuan, Xiaohui; Huang, Yuehua; Li, Xianshan; Li, Wenwu

    2015-05-01

    A hydraulic turbine regulating system (HTRS) is one of the most important components of hydropower plant, which plays a key role in maintaining safety, stability and economical operation of hydro-electrical installations. At present, the conventional PID controller is widely applied in the HTRS system for its practicability and robustness, and the primary problem with respect to this control law is how to optimally tune the parameters, i.e. the determination of PID controller gains for satisfactory performance. In this paper, a kind of multi-objective evolutionary algorithms, named adaptive grid particle swarm optimization (AGPSO) is applied to solve the PID gains tuning problem of the HTRS system. This newly AGPSO optimized method, which differs from a traditional one-single objective optimization method, is designed to take care of settling time and overshoot level simultaneously, in which a set of non-inferior alternatives solutions (i.e. Pareto solution) is generated. Furthermore, a fuzzy-based membership value assignment method is employed to choose the best compromise solution from the obtained Pareto set. An illustrative example associated with the best compromise solution for parameter tuning of the nonlinear HTRS system is introduced to verify the feasibility and the effectiveness of the proposed AGPSO-based optimization approach, as compared with two another prominent multi-objective algorithms, i.e. Non-dominated Sorting Genetic Algorithm II (NSGAII) and Strength Pareto Evolutionary Algorithm II (SPEAII), for the quality and diversity of obtained Pareto solutions set. Consequently, simulation results show that this AGPSO optimized approach outperforms than compared methods with higher efficiency and better quality no matter whether the HTRS system works under unload or load conditions.

  17. Women at Risk for Human Immunodeficiency Virus.

    ERIC Educational Resources Information Center

    Quadagno, David; And Others

    This article reports results from a survey among women at risk for contracting Human Immunodeficiency Virus (HIV) as well as transmitting it in a vertical (to offspring) and horizontal (sexual partner or intravenous [IV] drug usage) mode. Little is known about the extent of HIV knowledge, sexual behaviors, and IV drug usage for women at risk for…

  18. The Epidemiology of Human Immunodeficiency Virus Infection.

    ERIC Educational Resources Information Center

    Glasner, Peter D.; Kaslow, Richard A.

    1990-01-01

    Reviews epidemiology and natural history of human immunodeficiency virus-Type 1 (HIV-1) infection. Discusses early and late clinical manifestations, diagnosis of infection, incubation and latency periods, and survival time. Reviews data from published literature on distribution of HIV infection in adult United States population and factors that…

  19. Acquired immunodeficiency syndrome with subacute sclerosing panencephalitis.

    PubMed

    Gowda, Vykuntaraju K N; Sukanya, V; Shivananda

    2012-11-01

    A 7-year-old boy with acquired immunodeficiency syndrome, receiving antiretroviral drugs for 2 years, presented with a recent onset of myoclonic jerks and cognitive deterioration. On examination, he manifested myoclonic jerks once every 10-15 seconds. His electroencephalogram indicated periodic complexes, and his cerebrospinal fluid tested positive for measles antibodies.

  20. Newborn screening for severe combined immunodeficiency; the Wisconsin experience (2008-2011).

    PubMed

    Verbsky, James W; Baker, Mei W; Grossman, William J; Hintermeyer, Mary; Dasu, Trivikram; Bonacci, Benedetta; Reddy, Sreelatha; Margolis, David; Casper, James; Gries, Miranda; Desantes, Ken; Hoffman, Gary L; Brokopp, Charles D; Seroogy, Christine M; Routes, John M

    2012-02-01

    Severe combined immunodeficiency is a life-threatening primary immune deficiency characterized by low numbers of naïve T cells. Early diagnosis and treatment of this disease decreases mortality. In 2008, Wisconsin began newborn screening of infants for severe combined immunodeficiency and other forms of T-cell lymphopenia by the T-cell receptor excision circle assay. In total, 207,696 infants were screened. Seventy-two infants had an abnormal assay. T-cell numbers were normal in 38 infants, abnormal in 33 infants, and not performed in one infant, giving a positive predictive value for T-cell lymphopenia of any cause of 45.83% and a specificity of 99.98%. Five infants with severe combined immunodeficiency/severe T-cell lymphopenia requiring hematopoietic stem cell transplantation or other therapy were detected. In summary, the T-cell receptor excision circle assay is a sensitive and specific test to identify infants with severe combined immunodeficiency and severe T-cell lymphopenia that leads to life-saving therapies such as hematopoietic stem cell transplantation prior to the acquisition of severe infections.

  1. Transplantation Outcomes for Severe Combined Immunodeficiency, 2000–2009

    PubMed Central

    Pai, Sung-Yun; Logan, Brent R.; Griffith, Linda M.; Buckley, Rebecca H.; Parrott, Roberta E.; Dvorak, Christopher C.; Kapoor, Neena; Hanson, Imelda C.; Filipovich, Alexandra H.; Jyonouchi, Soma; Sullivan, Kathleen E.; Small, Trudy N.; Burroughs, Lauri; Skoda-Smith, Suzanne; Haight, Ann E.; Grizzle, Audrey; Pulsipher, Michael A.; Chan, Ka Wah; Fuleihan, Ramsay L.; Haddad, Elie; Loechelt, Brett; Aquino, Victor M.; Gillio, Alfred; Davis, Jeffrey; Knutsen, Alan; Smith, Angela R.; Moore, Theodore B.; Schroeder, Marlis L.; Goldman, Frederick D.; Connelly, James A.; Porteus, Matthew H.; Xiang, Qun; Shearer, William T.; Fleisher, Thomas A.; Kohn, Donald B.; Puck, Jennifer M.; Notarangelo, Luigi D.; Cowan, Morton J.; O’Reilly, Richard J.

    2014-01-01

    BACKGROUND The Primary Immune Deficiency Treatment Consortium was formed to analyze the results of hematopoietic-cell transplantation in children with severe combined immunodeficiency (SCID) and other primary immunodeficiencies. Factors associated with a good transplantation outcome need to be identified in order to design safer and more effective curative therapy, particularly for children with SCID diagnosed at birth. METHODS We collected data retrospectively from 240 infants with SCID who had received transplants at 25 centers during a 10-year period (2000 through 2009). RESULTS Survival at 5 years, freedom from immunoglobulin substitution, and CD3+ T-cell and IgA recovery were more likely among recipients of grafts from matched sibling donors than among recipients of grafts from alternative donors. However, the survival rate was high regardless of donor type among infants who received transplants at 3.5 months of age or younger (94%) and among older infants without prior infection (90%) or with infection that had resolved (82%). Among actively infected infants without a matched sibling donor, survival was best among recipients of haploidentical T-cell–depleted transplants in the absence of any pretransplantation conditioning. Among survivors, reduced-intensity or myeloablative pre-transplantation conditioning was associated with an increased likelihood of a CD3+ T-cell count of more than 1000 per cubic millimeter, freedom from immunoglobulin substitution, and IgA recovery but did not significantly affect CD4+ T-cell recovery or recovery of phytohemagglutinin-induced T-cell proliferation. The genetic subtype of SCID affected the quality of CD3+ T-cell recovery but not survival. CONCLUSIONS Transplants from donors other than matched siblings were associated with excellent survival among infants with SCID identified before the onset of infection. All available graft sources are expected to lead to excellent survival among asymptomatic infants. (Funded by the

  2. Tunning PID controller using particle swarm optimization algorithm on automatic voltage regulator system

    NASA Astrophysics Data System (ADS)

    Aranza, M. F.; Kustija, J.; Trisno, B.; Hakim, D. L.

    2016-04-01

    PID Controller (Proportional Integral Derivative) was invented since 1910, but till today still is used in industries, even though there are many kind of modern controllers like fuzz controller and neural network controller are being developed. Performance of PID controller is depend on on Proportional Gain (Kp), Integral Gain (Ki) and Derivative Gain (Kd). These gains can be got by using method Ziegler-Nichols (ZN), gain-phase margin, Root Locus, Minimum Variance dan Gain Scheduling however these methods are not optimal to control systems that nonlinear and have high-orde, in addition, some methods relative hard. To solve those obstacles, particle swarm optimization (PSO) algorithm is proposed to get optimal Kp, Ki and Kd. PSO is proposed because PSO has convergent result and not require many iterations. On this research, PID controller is applied on AVR (Automatic Voltage Regulator). Based on result of analyzing transient, stability Root Locus and frequency response, performance of PID controller is better than Ziegler-Nichols.

  3. Natural variation of rice blast resistance gene Pi-d2

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Studying natural variation of rice resistance (R) genes in cultivated and wild rice relatives can predict resistance stability to rice blast fungus. In the present study, the protein coding regions of rice R gene Pi-d2 in 35 rice accessions of subgroups, aus (AUS), indica (IND), temperate japonica (...

  4. Closed-loop step response for tuning PID-fractional-order-filter controllers.

    PubMed

    Amoura, Karima; Mansouri, Rachid; Bettayeb, Maâmar; Al-Saggaf, Ubaid M

    2016-09-01

    Analytical methods are usually applied for tuning fractional controllers. The present paper proposes an empirical method for tuning a new type of fractional controller known as PID-Fractional-Order-Filter (FOF-PID). Indeed, the setpoint overshoot method, initially introduced by Shamsuzzoha and Skogestad, has been adapted for tuning FOF-PID controller. Based on simulations for a range of first order with time delay processes, correlations have been derived to obtain PID-FOF controller parameters similar to those obtained by the Internal Model Control (IMC) tuning rule. The setpoint overshoot method requires only one closed-loop step response experiment using a proportional controller (P-controller). To highlight the potential of this method, simulation results have been compared with those obtained with the IMC method as well as other pertinent techniques. Various case studies have also been considered. The comparison has revealed that the proposed tuning method performs as good as the IMC. Moreover, it might offer a number of advantages over the IMC tuning rule. For instance, the parameters of the fractional controller are directly obtained from the setpoint closed-loop response data without the need of any model of the plant to be controlled.

  5. Nominal and robust stability regions of optimization-based PID controllers.

    PubMed

    Ou, Linlin; Zhang, Weidong; Gu, Danying

    2006-07-01

    In recent decades, several optimization-based methods have been developed for the proportional-integral-derivative (PID) controller design, and the common feature of these methods is that the controller has only one adjustable parameter. To keep the closed-loop systems stable is an essential requirement for the optimization-based PID controllers. In almost all these methods, however, no exact stability region for the single adjustable parameter was sketched. In this paper, using the proposed analytical procedure based on the dual-locus diagram technique, explicit stability regions of the optimization-based PID controllers are derived for stable, integrating, and unstable processes with time delay in the nominal and perturbed cases, respectively. It is revealed that the proposed analytical procedure is effective for the determination of the nominal and robust stability regions and it offers simplicity and ease of mathematical calculations over other available stability analysis methods. The results in this paper provide some insight into the tuning of the optimization-based PID controllers.

  6. A normalized PID controller in networked control systems with varying time delays.

    PubMed

    Tran, Hoang-Dung; Guan, Zhi-Hong; Dang, Xuan-Kien; Cheng, Xin-Ming; Yuan, Fu-Shun

    2013-09-01

    It requires not only simplicity and flexibility but also high specified stability and robustness of system to design a PI/PID controller in such complicated networked control systems (NCSs) with delays. By gain and phase margins approach, this paper proposes a novel normalized PI/PID controller for NCSs based on analyzing the stability and robustness of system under the effect of network-induced delays. Specifically, We take into account the total measured network delays to formulate the gain and phase margins of the closed-loop system in the form of a set of equations. With pre-specified values of gain and phase margins, this set of equations is then solved for calculating the closed forms of control parameters which enable us to propose the normalized PI/PID controller simultaneously satisfying the following two requirements: (1) simplicity without re-solving the optimization problem for a new process, (2) high flexibility to cope with large scale of random delays and deal with many different processes in different conditions of network. Furthermore, in our method, the upper bound of random delay can be estimated to indicate the operating domain of proposed PI/PID controller. Finally, simulation results are shown to demonstrate the advantages of our proposed controller in many situations of network-induced delays.

  7. Active sway control of a gantry crane using hybrid input shaping and PID control schemes

    NASA Astrophysics Data System (ADS)

    Mohd Tumari, M. Z.; Shabudin, L.; Zawawi, M. A.; Shah, L. H. Ahmad

    2013-12-01

    This project presents investigations into the development of hybrid input-shaping and PID control schemes for active sway control of a gantry crane system. The application of positive input shaping involves a technique that can reduce the sway by creating a common signal that cancels its own vibration and used as a feed-forward control which is for controlling the sway angle of the pendulum, while the proportional integral derivative (PID) controller is used as a feedback control which is for controlling the crane position. The PID controller was tuned using Ziegler-Nichols method to get the best performance of the system. The hybrid input-shaping and PID control schemes guarantee a fast input tracking capability, precise payload positioning and very minimal sway motion. The modeling of gantry crane is used to simulate the system using MATLAB/SIMULINK software. The results of the response with the controllers are presented in time domains and frequency domains. The performances of control schemes are examined in terms of level of input tracking capability, sway angle reduction and time response specification.

  8. Human immunodeficiency virus (HIV) is highly associated with giant idiopathic esophageal ulcers in acquired immunodeficiency syndrome (AIDS) patients

    PubMed Central

    Lv, Bei; Cheng, Xin; Gao, Jackson; Zhao, Hong; Chen, Liping; Wang, Liwei; Huang, Shaoping; Fan, Zhenyu; Zhang, Renfang; Shen, Yinzhong; Li, Lei; Liu, Baochi; Qi, Tangkai; Wang, Jing; Cheng, Jilin

    2016-01-01

    Objective: This study aimed to determine whether the human immunodeficiency virus (HIV) exists in giant idiopathic esophageal ulcers in the patients with acquired immune deficiency syndrome (AIDS). Methods: 16 AIDS patients with a primary complaint of epigastric discomfort were examined by gastroscopy. Multiple and giant esophageal ulcers were biopsied and analyzed with pathology staining and reverse transcription-polymerase chain reaction (RT-PCR) to determine the potential pathogenic microorganisms, including HIV, cytomegalovirus (CMV) and herpes simplex viruses (HSV). Results: HIV was detected in ulcer samples from 12 out of these 16 patients. Ulcers in 2 patients were infected with CMV and ulcers in another 2 patients were found HSV positive. No obvious cancerous pathological changes were found in these multiple giant esophageal ulcer specimens. Conclusion: HIV may be one of the major causative agents of multiple benign giant esophageal ulcers in AIDS patients. PMID:27830031

  9. Design and implementation of a new fuzzy PID controller for networked control systems.

    PubMed

    Fadaei, A; Salahshoor, K

    2008-10-01

    This paper presents a practical network platform to design and implement a networked-based cascade control system linking a Smar Foundation Fieldbus (FF) controller (DFI-302) and a Siemens programmable logic controller (PLC-S7-315-2DP) through Industrial Ethernet to a laboratory pilot plant. In the presented network configuration, the Smar OPC tag browser and Siemens WinCC OPC Channel provide the communicating interface between the two controllers. The paper investigates the performance of a PID controller implemented in two different possible configurations of FF function block (FB) and networked control system (NCS) via a remote Siemens PLC. In the FB control system implementation, the desired set-point is provided by the Siemens Human-Machine Interface (HMI) software (i.e, WinCC) via an Ethernet Modbus link. While, in the NCS implementation, the cascade loop is realized in remote Siemens PLC station and the final element set-point is sent to the Smar FF station via Ethernet bus. A new fuzzy PID control strategy is then proposed to improve the control performances of the networked-based control systems due to an induced transmission delay degradation effect. The proposed strategy utilizes an innovative idea based on sectionalizing the error signal of the step response into three different functional zones. The supporting philosophy behind these three functional zones is to decompose the desired control objectives in terms of rising time, settling time and steady-state error measures maintained by an appropriate PID-type controller in each zone. Then, fuzzy membership factors are defined to configure the control signal on the basis of the fuzzy weighted PID outputs of all three zones. The obtained results illustrate the effectiveness of the proposed fuzzy PID control scheme in improving the performances of the implemented NCS for different transportation delays.

  10. Combined immunodeficiency presenting with vaccine-associated paralytic poliomyelitis: a case report and narrative review of literature.

    PubMed

    Shaghaghi, Mohammadreza; Parvaneh, Nima; Ostad-Rahimi, Pouya; Fathi, Seyed Mohammad; Shahmahmoodi, Shohreh; Abolhassani, Hassan; Aghamohammadi, Asghar

    2014-01-01

    Neurologic abnormalities compatible with vaccine-related poliovirus infection (VAPP) may be a first presentation of some primary immunodeficient patients. The risk of VAPP rises from 1 case per 750 000 in normal population to 1 per 7000 times higher, particularly for persons with agammaglobulinemia and hypogammaglobulinemia. However, there is no appropriate estimation for VAPP occurrence in patients with cellular immunity defects. Herein we report a case of combined immunodeficiency with paralytic complication due to oral polio vaccine and we present a literature review on this topic.

  11. Simultaneous gains tuning in boiler/turbine PID-based controller clusters using iterative feedback tuning methodology.

    PubMed

    Zhang, Shu; Taft, Cyrus W; Bentsman, Joseph; Hussey, Aaron; Petrus, Bryan

    2012-09-01

    Tuning a complex multi-loop PID based control system requires considerable experience. In today's power industry the number of available qualified tuners is dwindling and there is a great need for better tuning tools to maintain and improve the performance of complex multivariable processes. Multi-loop PID tuning is the procedure for the online tuning of a cluster of PID controllers operating in a closed loop with a multivariable process. This paper presents the first application of the simultaneous tuning technique to the multi-input-multi-output (MIMO) PID based nonlinear controller in the power plant control context, with the closed-loop system consisting of a MIMO nonlinear boiler/turbine model and a nonlinear cluster of six PID-type controllers. Although simplified, the dynamics and cross-coupling of the process and the PID cluster are similar to those used in a real power plant. The particular technique selected, iterative feedback tuning (IFT), utilizes the linearized version of the PID cluster for signal conditioning, but the data collection and tuning is carried out on the full nonlinear closed-loop system. Based on the figure of merit for the control system performance, the IFT is shown to deliver performance favorably comparable to that attained through the empirical tuning carried out by an experienced control engineer.

  12. The Construct Validity of the Dutch Personality Inventory for DSM-5 Personality Disorders (PID-5) in a Clinical Sample.

    PubMed

    Bastiaens, Tim; Claes, Laurence; Smits, Dirk; De Clercq, Barbara; De Fruyt, Filip; Rossi, Gina; Vanwalleghem, Dominique; Vermote, Rudi; Lowyck, Benedicte; Claes, Stephan; De Hert, Marc

    2016-02-01

    The factor structure and the convergent validity of the Personality Inventory for DSM-5 (PID-5), a self-report questionnaire designed to measure personality pathology as advocated in the fifth edition, Section III of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are already demonstrated in general population samples, but need replication in clinical samples. In 240 Flemish inpatients, we examined the factor structure of the PID-5 by means of exploratory structural equation modeling. Additionally, we investigated differences in PID-5 higher order domain scores according to gender, age and educational level, and explored convergent and discriminant validity by relating the PID-5 with the Dimensional Assessment of Personality Pathology-Basic Questionnaire and by comparing PID-5 scores of inpatients with and without a DSM-IV categorical personality disorder diagnosis. Our results confirmed the original five-factor structure of the PID-5. The reliability and the convergent and discriminant validity of the PID-5 proved to be adequate. Implications for future research are discussed.

  13. Prolonged excretion of type-2 poliovirus from a primary immune deficient patient during the transition to a type-2 poliovirus-free world, Israel, 2016

    PubMed Central

    Weil, Merav; Shulman, Lester M; Heiman, Sophia; Stauber, Tali; Alfandari, Jacqueline; Weiss, Leah; Silberstein, Ilana; Indenbaum, Viki; Mendelson, Ella; Sofer, Danit

    2016-01-01

    Wild poliovirus type-2 has been eradicated, use of live type-2 vaccine has been terminated globally, and all type-2 polioviruses are under strict laboratory containment protocols. Re-emergence may arise from prolonged asymptomatic excretion of poliovirus by hospitalised primary immune deficient (PID) patients, as described here, through repeated exposure of close contacts to high titres of infected material. At this transition time, PID patients should be screened and hospital containment protocols updated in parallel with laboratory containment. PMID:27918258

  14. Otic and ophthalmic pneumocystosis in acquired immunodeficiency syndrome. Report of a case and review of the literature.

    PubMed

    Wasserman, L; Haghighi, P

    1992-05-01

    A case of primary Pneumocystis carinii infection involving the left middle ear of a patient with acquired immunodeficiency syndrome is described, and the literature on the otic and ophthalmic pneumocystosis is reviewed. Otic pneumocystosis typically presents as a unilateral polypoid mass, and it is clinically manifested as otalgia, hearing loss, or, sometimes, otorrhea without evidence of current respiratory disease or previous Pneumocystis pneumonia. In contrast, choroidal pneumocystosis usually occurs in a patient with acquired immunodeficiency syndrome with at least one previous episode of Pneumocystis pneumonia and aerosolized pentamidine treatment, it is usually asymptomatic and bilateral, and it may be discovered only because of other concurrent human immunodeficiency virus-related ophthalmic disease. The diagnosis is made clinically, and intravenous antiparasite treatment is successful.

  15. Dyschromia related to severe combined immunodeficiency.

    PubMed

    Maldonado-Cid, Paola; Noguera-Morel, Lucero; Moreno-Alonso-de-Celada, Ricardo; De-Lucas-Laguna, Raúl; Feito-Rodríguez, Marta; Beato-Merino, Maria José; Casado-Jiménez, Mariano

    2013-12-01

    Severe combined immunodeficiency includes a group of diseases characterized by different inherited immunological defects. A 4-month-old girl diagnosed with Omenn syndrome, a subtype of severe combined immunodeficiency presenting with generalized erythroderma, was referred to our hospital for an allogeneic stem cell transplantation. Days before transplantation, she developed hyperpigmented macules that increased in number in the following months. As the erythroderma resolved after transplantation, diffuse hypopigmentation was simultaneously noted together with the expansion of hyperpigmented lesions. Cutaneous biopsy samples were taken at different moments, showing features of Omenn syndrome at first, and 2 months later changes consistent with hypopigmentation and repigmentation were observed. Although pigmentary disorders are rarely described in this context, these must be taken into account as a possible alternative diagnosis to graft-versus-host disease and toxicoderma in immunosuppressed patients.

  16. Human Immunodeficiency Virus (HIV) Research (AIDS)

    DTIC Science & Technology

    1991-02-28

    data and case definitions. By 1985 a virus, named at that time HTLV III, had been identified as the infectious agent of AIDS and the transmission of...in the military. HTLV III became internationally accepted as the human immunodeficiency virus (HIV) and the testing became the organized and...with the National Institute of Arthritis and Musculoskeletal and Skin Diseases to "conduct clinical and epidemiological studies of cutaneous

  17. Thermal inactivation of bovine immunodeficiency virus.

    PubMed Central

    Moore, E C; Keil, D; Coats, K S

    1996-01-01

    Cell-associated bovine immunodeficiency virus (BIV) and cell-free BIV were subjected to increasing temperatures, including pasteurization conditions. To determine the effect of heat treatment on BIV viability, reverse transcriptase activity and infectivity of the heat-treated virus were assessed. BIV was inactivated by heating to 47 degrees C for 30 min and by low- and high-temperature pasteurization conditions. PMID:8900024

  18. Silvery grey hair: clue to diagnose immunodeficiency.

    PubMed

    Sahana, Ms; Sacchidanand, S; Hiremagalore, R; Asha, Gs

    2012-04-01

    Silvery hair is a common presentation of rare group of autosomal recessive disorders called Silvery hair syndromes including Griscelli syndrome (GS), Chediak-Higashi syndrome, and Elejalde syndrome. GS is characterized by a silvery grey sheen to hair, large clumped melanosomes in hair shaft, partial albinism, and variable cellular immunodeficiency. We report two cases of GS with classical clinical features and confirmatory findings by microscopic skin and hair examination.

  19. Obstructive endocarditis in an immunodeficient infant.

    PubMed

    Walters, M D; Deanfield, J E; Robinson, P J; Matthew, D J

    1986-12-01

    We report the case of 5-week-old male infant who presented as a 'near miss cot death'. He had the immunodeficient syndrome of defective neutrophil mobility and delayed umbilical cord separation. He was shown to have staphylococcal endocarditis with a large vegetation on the mitral valve, and acute obstruction of the mitral valve flow may have accounted for the suddenness of his presentation. Death resulted from overwhelming sepsis with widely disseminated micro-abscesses.

  20. Antiviral drugs for viruses other than human immunodeficiency virus.

    PubMed

    Razonable, Raymund R

    2011-10-01

    Most viral diseases, with the exception of those caused by human immunodeficiency virus, are self-limited illnesses that do not require specific antiviral therapy. The currently available antiviral drugs target 3 main groups of viruses: herpes, hepatitis, and influenza viruses. With the exception of the antisense molecule fomivirsen, all antiherpes drugs inhibit viral replication by serving as competitive substrates for viral DNA polymerase. Drugs for the treatment of influenza inhibit the ion channel M(2) protein or the enzyme neuraminidase. Combination therapy with Interferon-α and ribavirin remains the backbone treatment for chronic hepatitis C; the addition of serine protease inhibitors improves the treatment outcome of patients infected with hepatitis C virus genotype 1. Chronic hepatitis B can be treated with interferon or a combination of nucleos(t)ide analogues. Notably, almost all the nucleos(t) ide analogues for the treatment of chronic hepatitis B possess anti-human immunodeficiency virus properties, and they inhibit replication of hepatitis B virus by serving as competitive substrates for its DNA polymerase. Some antiviral drugs possess multiple potential clinical applications, such as ribavirin for the treatment of chronic hepatitis C and respiratory syncytial virus and cidofovir for the treatment of cytomegalovirus and other DNA viruses. Drug resistance is an emerging threat to the clinical utility of antiviral drugs. The major mechanisms for drug resistance are mutations in the viral DNA polymerase gene or in genes that encode for the viral kinases required for the activation of certain drugs such as acyclovir and ganciclovir. Widespread antiviral resistance has limited the clinical utility of M(2) inhibitors for the prevention and treatment of influenza infections. This article provides an overview of clinically available antiviral drugs for the primary care physician, with a special focus on pharmacology, clinical uses, and adverse effects.

  1. Antiviral Drugs for Viruses Other Than Human Immunodeficiency Virus

    PubMed Central

    Razonable, Raymund R.

    2011-01-01

    Most viral diseases, with the exception of those caused by human immunodeficiency virus, are self-limited illnesses that do not require specific antiviral therapy. The currently available antiviral drugs target 3 main groups of viruses: herpes, hepatitis, and influenza viruses. With the exception of the antisense molecule fomivirsen, all antiherpes drugs inhibit viral replication by serving as competitive substrates for viral DNA polymerase. Drugs for the treatment of influenza inhibit the ion channel M2 protein or the enzyme neuraminidase. Combination therapy with Interferon-α and ribavirin remains the backbone treatment for chronic hepatitis C; the addition of serine protease inhibitors improves the treatment outcome of patients infected with hepatitis C virus genotype 1. Chronic hepatitis B can be treated with interferon or a combination of nucleos(t)ide analogues. Notably, almost all the nucleos(t) ide analogues for the treatment of chronic hepatitis B possess anti–human immunodeficiency virus properties, and they inhibit replication of hepatitis B virus by serving as competitive substrates for its DNA polymerase. Some antiviral drugs possess multiple potential clinical applications, such as ribavirin for the treatment of chronic hepatitis C and respiratory syncytial virus and cidofovir for the treatment of cytomegalovirus and other DNA viruses. Drug resistance is an emerging threat to the clinical utility of antiviral drugs. The major mechanisms for drug resistance are mutations in the viral DNA polymerase gene or in genes that encode for the viral kinases required for the activation of certain drugs such as acyclovir and ganciclovir. Widespread antiviral resistance has limited the clinical utility of M2 inhibitors for the prevention and treatment of influenza infections. This article provides an overview of clinically available antiviral drugs for the primary care physician, with a special focus on pharmacology, clinical uses, and adverse effects. PMID

  2. Mycobacterial disease, immunosuppression, and acquired immunodeficiency syndrome.

    PubMed Central

    Collins, F M

    1989-01-01

    The mycobacteria are an important group of acid-fast pathogens ranging from obligate intracellular parasites such as Mycobacterium leprae to environmental species such as M. gordonae and M. fortuitum. The latter may behave as opportunistic human pathogens if the host defenses have been depleted in some manner. The number and severity of such infections have increased markedly with the emergence of the acquired immunodeficiency syndrome (AIDS) epidemic. These nontuberculous mycobacteria tend to be less virulent for humans than M. tuberculosis, usually giving rise to self-limiting infections involving the cervical and mesenteric lymph nodes of young children. However, the more virulent serovars of M. avium complex can colonize the bronchial and intestinal mucosal surfaces of healthy individuals, becoming virtual members of the commensal gut microflora and thus giving rise to low levels of skin hypersensitivity to tuberculins prepared from M. avium and M. intracellulare. Systemic disease develops when the normal T-cell-mediated defenses become depleted as a result of old age, cancer chemotherapy, or infection with human immunodeficiency virus. As many as 50% of human immunodeficiency virus antibody-positive individuals develop mycobacterial infections at some time during their disease. Most isolates of M. avium complex from AIDS patients fall into serotypes 4 and 8. The presence of these drug-resistant mycobacteria in the lungs of the AIDS patient makes their effective clinical treatment virtually impossible. More effective chemotherapeutic, prophylactic, and immunotherapeutic reagents are urgently needed to treat this rapidly increasing patient population. PMID:2680057

  3. Pharmacological Inhibition of Feline Immunodeficiency Virus (FIV)

    PubMed Central

    Mohammadi, Hakimeh; Bienzle, Dorothee

    2012-01-01

    Feline immunodeficiency virus (FIV) is a member of the retroviridae family of viruses and causes an acquired immunodeficiency syndrome (AIDS) in domestic and non-domestic cats worldwide. Genome organization of FIV and clinical characteristics of the disease caused by the virus are similar to those of human immunodeficiency virus (HIV). Both viruses infect T lymphocytes, monocytes and macrophages, and their replication cycle in infected cells is analogous. Due to marked similarity in genomic organization, virus structure, virus replication and disease pathogenesis of FIV and HIV, infection of cats with FIV is a useful tool to study and develop novel drugs and vaccines for HIV. Anti-retroviral drugs studied extensively in HIV infection have targeted different steps of the virus replication cycle: (1) inhibition of virus entry into susceptible cells at the level of attachment to host cell surface receptors and co-receptors; (2) inhibition of fusion of the virus membrane with the cell membrane; (3) blockade of reverse transcription of viral genomic RNA; (4) interruption of nuclear translocation and viral DNA integration into host genomes; (5) prevention of viral transcript processing and nuclear export; and (6) inhibition of virion assembly and maturation. Despite much success of anti-retroviral therapy slowing disease progression in people, similar therapy has not been thoroughly investigated in cats. In this article we review current pharmacological approaches and novel targets for anti-lentiviral therapy, and critically assess potentially suitable applications against FIV infection in cats. PMID:22754645

  4. Feline Immunodeficiency Virus in South America

    PubMed Central

    Teixeira, Bruno M.; Hagiwara, Mitika K.; Cruz, Juliano C. M.; Hosie, Margaret J.

    2012-01-01

    The rapid emergence of AIDS in humans during the period between 1980 and 2000 has led to extensive efforts to understand more fully similar etiologic agents of chronic and progressive acquired immunodeficiency disease in several mammalian species. Lentiviruses that have gene sequence homology with human immunodeficiency virus (HIV) have been found in different species (including sheep, goats, horses, cattle, cats, and several Old World monkey species). Lentiviruses, comprising a genus of the Retroviridae family, cause persistent infection that can lead to varying degrees of morbidity and mortality depending on the virus and the host species involved. Feline immunodeficiency virus (FIV) causes an immune system disease in domestic cats (Felis catus) involving depletion of the CD4+ population of T lymphocytes, increased susceptibility to opportunistic infections, and sometimes death. Viruses related to domestic cat FIV occur also in a variety of nondomestic felids. This is a brief overview of the current state of knowledge of this large and ancient group of viruses (FIVs) in South America. PMID:22590677

  5. The case for newborn screening for severe combined immunodeficiency and related disorders

    PubMed Central

    Puck, Jennifer M.

    2015-01-01

    Early detection of primary immunodeficiency is recognized as important for avoiding infectious complications that compromise outcomes. In particular, severe combined immunodeficiency (SCID) is fatal in infancy unless affected infants can be diagnosed before the onset of devastating infections and provided with an immune system through allogenic hematopoietic cell transplantation, enzyme replacement, or gene therapy. A biomarker of normal T cell development, T cell receptor excision circles (TRECs), can be measured in DNA isolated from the dried blood spots routinely obtained for newborn screening; infants identified as lacking TRECs can thus receive confirmatory testing and prompt intervention. Early results of TREC testing of newborns in five states indicate that this addition to the newborn screening panel can be successfully integrated into state public health programs. A variety of cases with typical SCID genotypes and other T lymphocytopenic conditions have been detected in a timely manner and referred for appropriate early treatment. PMID:22236435

  6. The case for newborn screening for severe combined immunodeficiency and related disorders.

    PubMed

    Puck, Jennifer M

    2011-12-01

    Early detection of primary immunodeficiency is recognized as important for avoiding infectious complications that compromise outcomes. In particular, severe combined immunodeficiency (SCID) is fatal in infancy unless affected infants can be diagnosed before the onset of devastating infections and provided with an immune system through allogenic hematopoietic cell transplantation, enzyme replacement, or gene therapy. A biomarker of normal T cell development, T cell receptor excision circles (TRECs), can be measured in DNA isolated from the dried blood spots routinely obtained for newborn screening; infants identified as lacking TRECs can thus receive confirmatory testing and prompt intervention. Early results of TREC testing of newborns in five states indicate that this addition to the newborn screening panel can be successfully integrated into state public health programs. A variety of cases with typical SCID genotypes and other T lymphocytopenic conditions have been detected in a timely manner and referred for appropriate early treatment.

  7. Novel NLRP12 mutations associated with intestinal amyloidosis in a patient diagnosed with common variable immunodeficiency.

    PubMed

    Borte, Stephan; Celiksoy, Mehmet Halil; Menzel, Volker; Ozkaya, Ozan; Ozen, Fatma Zeynep; Hammarström, Lennart; Yildiran, Alisan

    2014-10-01

    Heterozygous mutations in the NLRP12 gene have been found in patients with systemic auto-inflammatory diseases. However, the NLRP12-associated periodic fever syndromes show a wide clinical spectrum, including patients without classical diagnostic symptoms. Here, we report on a 20-year-old female patient diagnosed with common variable immunodeficiency (CVID), who developed intestinal amyloidosis and carried novel compound heterozygous mutations in NLRP12, identified by whole exome and transcriptome sequencing. CVID is a primary immunodeficiency characterized by low serum immunoglobulins, recurrent bacterial infections and development of malignancy, but it also presents with a magnitude of autoimmune features. Because of the unspecific heterogeneous clinical features of the disease, a delay in diagnosis is common. Secondary, inflammatory (AA type) amyloidosis has infrequently been observed in CVID patients. Based on our case observation and a critical review of the literature, we suggest that NLRP12 mutations might account for a small fraction of CVID patients with severe auto-inflammatory complications.

  8. Altered Virome and Bacterial Microbiome in Human Immunodeficiency Virus-Associated Acquired Immunodeficiency Syndrome.

    PubMed

    Monaco, Cynthia L; Gootenberg, David B; Zhao, Guoyan; Handley, Scott A; Ghebremichael, Musie S; Lim, Efrem S; Lankowski, Alex; Baldridge, Megan T; Wilen, Craig B; Flagg, Meaghan; Norman, Jason M; Keller, Brian C; Luévano, Jesús Mario; Wang, David; Boum, Yap; Martin, Jeffrey N; Hunt, Peter W; Bangsberg, David R; Siedner, Mark J; Kwon, Douglas S; Virgin, Herbert W

    2016-03-09

    Human immunodeficiency virus (HIV) infection is associated with increased intestinal translocation of microbial products and enteropathy as well as alterations in gut bacterial communities. However, whether the enteric virome contributes to this infection and resulting immunodeficiency remains unknown. We characterized the enteric virome and bacterial microbiome in a cohort of Ugandan patients, including HIV-uninfected or HIV-infected subjects and those either treated with anti-retroviral therapy (ART) or untreated. Low peripheral CD4 T cell counts were associated with an expansion of enteric adenovirus sequences and this increase was independent of ART treatment. Additionally, the enteric bacterial microbiome of patients with lower CD4 T counts exhibited reduced phylogenetic diversity and richness with specific bacteria showing differential abundance, including increases in Enterobacteriaceae, which have been associated with inflammation. Thus, immunodeficiency in progressive HIV infection is associated with alterations in the enteric virome and bacterial microbiome, which may contribute to AIDS-associated enteropathy and disease progression.

  9. New results on the robust stability of PID controllers with gain and phase margins for UFOPTD processes.

    PubMed

    Jin, Q B; Liu, Q; Huang, B

    2016-03-01

    This paper considers the problem of determining all the robust PID (proportional-integral-derivative) controllers in terms of the gain and phase margins (GPM) for open-loop unstable first order plus time delay (UFOPTD) processes. It is the first time that the feasible ranges of the GPM specifications provided by a PID controller are given for UFOPTD processes. A gain and phase margin tester is used to modify the original model, and the ranges of the margin specifications are derived such that the modified model can be stabilized by a stabilizing PID controller based on Hermite-Biehlers Theorem. Furthermore, we obtain all the controllers satisfying a given margin specification. Simulation studies show how to use the results to design a robust PID controller.

  10. Trait Variance and Response Style Variance in the Scales of the Personality Inventory for DSM-5 (PID-5).

    PubMed

    Ashton, Michael C; de Vries, Reinout E; Lee, Kibeom

    2017-01-01

    Using self- and observer reports on the Personality Inventory for DSM-5 (PID-5) and the HEXACO Personality Inventory-Revised (HEXACO-PI-R), we identified for each inventory several trait dimensions (each defined by both self- and observer reports on the facet-level scales belonging to the same domain) and 2 source dimensions (each defined by self-reports or by observer reports, respectively, on all facet-level scales). Results (N = 217) showed that the source dimensions of the PID-5 were very large (much larger than those of the HEXACO-PI-R), and suggest that self-report (or observer report) response styles substantially inflate the intercorrelations and the alpha reliabilities of the PID-5 scales. We discuss the meaning and the implications of the large PID-5 source components, and we suggest some methods of controlling their influence.

  11. Hematologic disorders associated with human immunodeficiency virus and AIDS.

    PubMed

    Cosby, Cecily D

    2007-01-01

    Nurses encounter patients with human immunodeficiency virus infection at various stages of their infection and in a variety of settings. This article focuses on the most common hematologic disorders associated with human immunodeficiency virus infection and acquired immunodeficiency syndrome, which can precipitate complications and frequently accompany hospitalization. It is important for nurses to have a solid foundation as to the cause of these disorders, their impact on quality of life and outcomes, and management strategies.

  12. Severe combined immunodeficiency due to adenosine deaminase deficiency.

    PubMed

    Hussain, Waqar; Batool, Asma; Ahmed, Tahir Aziz; Bashir, Muhammad Mukarram

    2012-03-01

    Severe Combined Immunodeficiency is the term applied to a group of rare genetic disorders characterised by defective or absent T and B cell functions. Patients usually present in first 6 months of life with respiratory/gastrointestinal tract infections and failure to thrive. Among the various types of severe combined immunodeficiency, enzyme deficiencies are relatively less common. We report the case of a 6 years old girl having severe combined immunodeficiency due to adenosine deaminase deficiency.

  13. Experimental results on the design for the APS PID global orbit control system.

    SciTech Connect

    Chung, Y.; Kirchman, J. A.

    1997-12-05

    The Advanced Photon Source third generation synchrotrons light source needs a stabilized particle beam position to produce high brightness and low emittance radiation. Global orbit correction control is introduced and is utilized to satisfy the demanding needs of the accelerator. This paper presents the experimental results for determining an effective and optimal controller to meet the global orbit correction requirements. These requirements include frequency/time domain demands consisting of vibrational noise attenuation, limiting of controller gains for stability and improving the system time response. Experiments were conducted with a digital signal processor implementing various PID sets to make comparisons between simulations and experiments. Measurements at these PID sets supported the results of software simulation.

  14. Stability domains of the delay and PID coefficients for general time-delay systems

    NASA Astrophysics Data System (ADS)

    Almodaresi, Elham; Bozorg, Mohammad; Taghirad, Hamid D.

    2016-04-01

    Time delays are encountered in many physical systems, and they usually threaten the stability and performance of closed-loop systems. The problem of determining all stabilising proportional-integral-derivative (PID) controllers for systems with perturbed delays is less investigated in the literature. In this study, the Rekasius substitution is employed to transform the system parameters to a new space. Then, the singular frequency (SF) method is revised for the Rekasius transformed system. A novel technique is presented to compute the ranges of time delay for which stable PID controller exists. This stability range cannot be readily computed from the previous methods. Finally, it is shown that similar to the original SF method, finite numbers of singular frequencies are sufficient to compute the stable regions in the space of time delay and controller coefficients.

  15. The power stability of a fiber amplifier based on a multifunction card and PID control program

    NASA Astrophysics Data System (ADS)

    Zhang, Linjie; Yang, Wenguang; Zhang, Hao; Zhao, JianMing; Jia, Suotang

    2016-06-01

    The power stability of a fiber amplifier was significantly improved by means of simultaneously controlling the current of a fiber amplifier and the diffraction efficiency of an acousto-optical modulator. The real-time fluctuation of laser power was recorded by a multifunction card and processed by a proportional-integral-derivative (PID) control program. The feedback loop voltage was introduced to the fiber laser amplifier and acoustic-optic modulator through the analog output of the multifunction card. The control method based on a multifunction card and PID program has good scalability, flexibility and reliability for the complex system on the condition in which the frequency and power of the laser need to be precisely stabilized.

  16. Implementation of motor speed control using PID control in programmable logic controller

    NASA Astrophysics Data System (ADS)

    Samin, R. E.; Azmi, N. A.; Ahmad, M. A.; Ghazali, M. R.; Zawawi, M. A.

    2012-11-01

    This paper presents the implementation of motor speed control using Proportional Integral Derrivative (PID) controller using Programmable Logic Controller (PLC). Proportional Integral Derrivative (PID) controller is the technique used to actively control the speed of the motor. An AC motor is used in the research together with the PLC, encoder and Proface touch screen. The model of the PLC that has been used in this project is OMRON CJIG-CPU42P where this PLC has a build in loop control that can be made the ladder diagram quite simple using function block in CX-process tools. A complete experimental analysis of the technique in terms of system response is presented. Comparative assessment of the impact of Proportional, Integral and Derivative in the controller on the system performance is presented and discussed.

  17. A Novel Memristive Multilayer Feedforward Small-World Neural Network with Its Applications in PID Control

    PubMed Central

    Dong, Zhekang; Duan, Shukai; Hu, Xiaofang; Wang, Lidan

    2014-01-01

    In this paper, we present an implementation scheme of memristor-based multilayer feedforward small-world neural network (MFSNN) inspirited by the lack of the hardware realization of the MFSNN on account of the need of a large number of electronic neurons and synapses. More specially, a mathematical closed-form charge-governed memristor model is presented with derivation procedures and the corresponding Simulink model is presented, which is an essential block for realizing the memristive synapse and the activation function in electronic neurons. Furthermore, we investigate a more intelligent memristive PID controller by incorporating the proposed MFSNN into intelligent PID control based on the advantages of the memristive MFSNN on computation speed and accuracy. Finally, numerical simulations have demonstrated the effectiveness of the proposed scheme. PMID:25202723

  18. Decentralized PI/PID controllers based on gain and phase margin specifications for TITO processes.

    PubMed

    Maghade, D K; Patre, B M

    2012-07-01

    In this paper, a decentralized PI/PID controller design method based on gain and phase margin specifications for two-input-two-output (TITO) interactive processes is proposed. The decouplers are designed for systems to minimize the interaction between the loops, and the first order plus dead time (FOPDT) model is achieved for each decoupled subsystem based on the frequency response fitting. An independent PI/PID controller is designed for each reduced order decoupled subsystem to obtain the desired gain and phase margins, and the performance is verified on the original interactive system to show the effectiveness of the proposed design method for the general class of TITO systems. Simulation examples are incorporated to validate the usefulness of the presented algorithm. An experimentation is performed on the Level-Temperature reactor process to show the practical applicability of the proposed method for the interactive system.

  19. A new autotuning algorithm for PID controllers using dead-beat format.

    PubMed

    Bandyopadhyay, R; Patranabis, D

    2001-01-01

    A novel algorithm for PID controllers based on dead-beat control and fuzzy inference mechanism is presented in this paper. The proposition is an extension of the work by the authors where the PI form of the algorithm was presented. The inclusion of the derivative term makes the method suitable for application in all types of processes including the ones having high rate disturbances. The proposed algorithm seems to be a complete and generalized PID autotuner as can be seen by the simulated and experimental results. In all the cases the method shows substantial improvement over the controller tuned with Ziegler Nichol's formula and the PI controller proposed in R. Bandyopadhyay, D. Patranabis, A fuzzy logic based PI autotuner, ISA Transactions 37 (1998) 227-235.

  20. Chicken barn climate and hazardous volatile compounds control using simple linear regression and PID

    NASA Astrophysics Data System (ADS)

    Abdullah, A. H.; Bakar, M. A. A.; Shukor, S. A. A.; Saad, F. S. A.; Kamis, M. S.; Mustafa, M. H.; Khalid, N. S.

    2016-07-01

    The hazardous volatile compounds from chicken manure in chicken barn are potentially to be a health threat to the farm animals and workers. Ammonia (NH3) and hydrogen sulphide (H2S) produced in chicken barn are influenced by climate changes. The Electronic Nose (e-nose) is used for the barn's air, temperature and humidity data sampling. Simple Linear Regression is used to identify the correlation between temperature-humidity, humidity-ammonia and ammonia-hydrogen sulphide. MATLAB Simulink software was used for the sample data analysis using PID controller. Results shows that the performance of PID controller using the Ziegler-Nichols technique can improve the system controller to control climate in chicken barn.

  1. PID and PLC units for the real-time control of sewer systems.

    PubMed

    Campisano, A; Modica, C

    2002-01-01

    Moveable gates for the real-time control (RTC) of sewer systems storage capacities are usually operated by controllers which, on the basis of local water level or flow velocity measurements, calculate the regulation errors of the monitored variables, determining the necessary regulator movements to lead the flow conditions to the desired set point. In this paper the results of an investigation on the influence of proportional-integral-derivative (PID) controllers and programmable logic controllers (PLC) for the RTC of moveable sluice gates positioned into sewer systems are presented. The analysis of response time, damping and regulation errors provided information on the PID parameter calibration values and on the PLC control function performances. A comparison between the two kind of controllers has also been carried out.

  2. A PSO-PID quaternion model based trajectory control of a hexarotor UAV

    NASA Astrophysics Data System (ADS)

    Artale, Valeria; Milazzo, Cristina L. R.; Orlando, Calogero; Ricciardello, Angela

    2015-12-01

    A quaternion based trajectory controller for a prototype of an Unmanned Aerial Vehicle (UAV) is discussed in this paper. The dynamics of the UAV, a hexarotor in details, is described in terms of quaternion instead of the usual Euler angle parameterization. As UAV flight management concerns, the method here implemented consists of two main steps: trajectory and attitude control via Proportional-Integrative-Derivative (PID) and Proportional-Derivative (PD) technique respectively and the application of Particle Swarm Optimization (PSO) method in order to tune the PID and PD parameters. The optimization is the consequence of the minimization of a objective function related to the error with the respect to a proper trajectory. Numerical simulations support and validate the proposed method.

  3. An optimal PID controller via LQR for standard second order plus time delay systems.

    PubMed

    Srivastava, Saurabh; Misra, Anuraag; Thakur, S K; Pandit, V S

    2016-01-01

    An improved tuning methodology of PID controller for standard second order plus time delay systems (SOPTD) is developed using the approach of Linear Quadratic Regulator (LQR) and pole placement technique to obtain the desired performance measures. The pole placement method together with LQR is ingeniously used for SOPTD systems where the time delay part is handled in the controller output equation instead of characteristic equation. The effectiveness of the proposed methodology has been demonstrated via simulation of stable open loop oscillatory, over damped, critical damped and unstable open loop systems. Results show improved closed loop time response over the existing LQR based PI/PID tuning methods with less control effort. The effect of non-dominant pole on the stability and robustness of the controller has also been discussed.

  4. IMC-PID-fractional-order-filter controllers design for integer order systems.

    PubMed

    Maâmar, Bettayeb; Rachid, Mansouri

    2014-09-01

    One of the reasons of the great success of standard PID controllers is the presence of simple tuning rules, of the automatic tuning feature and of tables that simplify significantly their design. For the fractional order case, some tuning rules have been proposed in the literature. However, they are not general because they are valid only for some model cases. In this paper, a new approach is investigated. The fractional property is not especially imposed by the controller structure but by the closed loop reference model. The resulting controller is fractional but it has a very interesting structure for its implementation. Indeed, the controller can be decomposed into two transfer functions: an integer transfer function which is generally an integer PID controller and a simple fractional filter.

  5. The hierarchical expert tuning of PID controllers using tools of soft computing.

    PubMed

    Karray, F; Gueaieb, W; Al-Sharhan, S

    2002-01-01

    We present soft computing-based results pertaining to the hierarchical tuning process of PID controllers located within the control loop of a class of nonlinear systems. The results are compared with PID controllers implemented either in a stand alone scheme or as a part of conventional gain scheduling structure. This work is motivated by the increasing need in the industry to design highly reliable and efficient controllers for dealing with regulation and tracking capabilities of complex processes characterized by nonlinearities and possibly time varying parameters. The soft computing-based controllers proposed are hybrid in nature in that they integrate within a well-defined hierarchical structure the benefits of hard algorithmic controllers with those having supervisory capabilities. The controllers proposed also have the distinct features of learning and auto-tuning without the need for tedious and computationally extensive online systems identification schemes.

  6. Tuning of PID controllers for integrating systems using direct synthesis method.

    PubMed

    Anil, Ch; Padma Sree, R

    2015-07-01

    A PID controller is designed for various forms of integrating systems with time delay using direct synthesis method. The method is based on comparing the characteristic equation of the integrating system and PID controller with a filter with the desired characteristic equation. The desired characteristic equation comprises of multiple poles which are placed at the same desired location. The tuning parameter is adjusted so as to achieve the desired robustness. Tuning rules in terms of process parameters are given for various forms of integrating systems. The tuning parameter can be selected for the desired robustness by specifying Ms value. The proposed controller design method is applied to various transfer function models and to the nonlinear model equations of jacketed CSTR to show its effectiveness and applicability.

  7. Performance Analysis of Fuzzy-PID Controller for Blood Glucose Regulation in Type-1 Diabetic Patients.

    PubMed

    Yadav, Jyoti; Rani, Asha; Singh, Vijander

    2016-12-01

    This paper presents Fuzzy-PID (FPID) control scheme for a blood glucose control of type 1 diabetic subjects. A new metaheuristic Cuckoo Search Algorithm (CSA) is utilized to optimize the gains of FPID controller. CSA provides fast convergence and is capable of handling global optimization of continuous nonlinear systems. The proposed controller is an amalgamation of fuzzy logic and optimization which may provide an efficient solution for complex problems like blood glucose control. The task is to maintain normal glucose levels in the shortest possible time with minimum insulin dose. The glucose control is achieved by tuning the PID (Proportional Integral Derivative) and FPID controller with the help of Genetic Algorithm and CSA for comparative analysis. The designed controllers are tested on Bergman minimal model to control the blood glucose level in the facets of parameter uncertainties, meal disturbances and sensor noise. The results reveal that the performance of CSA-FPID controller is superior as compared to other designed controllers.

  8. Fuzzy auto-tuning PID control of multiple joint robot driven by ultrasonic motors.

    PubMed

    Sun, Zhijun; Xing, Rentao; Zhao, Chunsheng; Huang, Weiqing

    2007-11-01

    A three-joint robot is directly driven by ultrasonic motors with advantage of high torque at low speed. The speed of the ultrasonic motors is actually controlled by regulating their operating frequencies. The kinematic and kinetic analyses of the robot have been carried out using Adams. Due to the lack of accurate control model of ultrasonic motors and the time-varying motor parameters, a fuzzy auto-tuning proportional integral derivative (PID) controller for the robot is experimented, in which a simple method to tune parameters of the PID type fuzzy controller on-line is developed and a new position-speed feedback strategy is proposed and implemented. The effectiveness of the proposed control strategy and fuzzy logic controller is verified by experimental investigation.

  9. Human immunodeficiency virus disease in California. Effects of the 1993 expanded case definition of the acquired immunodeficiency syndrome.

    PubMed Central

    Singleton, J A; Tabnak, F; Kuan, J; Rutherford, G W

    1996-01-01

    On January 1, 1993, the case definition of the acquired immunodeficiency syndrome (AIDS) in adults and adolescents used for monitoring the AIDS epidemic in California was expanded to include persons infected with the human immunodeficiency virus (HIV) with CD4 T-lymphocyte counts of less than 200 x 10(6) per liter (< 200 per mm3), pulmonary tuberculosis, recurrent pneumonia, or invasive cervical cancer. To assess the implications of this revision on AIDS case reporting in California, we compared cases reported through the end of 1994 based on 1 or more of the 4 new AIDS-defining conditions added in 1993 to cases reported based on pre-1993 AIDS-defining opportunistic infections and cancers. The 4 new conditions included in the 1993 expanded AIDS case definition accounted for a 23% increase in cumulative AIDS cases reported in California by the end of 1993, a 170% increase in the number of cases reported during 1993, and an 88% increase in the number of patients with AIDS living at the end of 1993. The number of cases reported in 1993 (19,629) was 124% more than that reported in 1992 (8,780) and 69% more than that reported in 1994 (11,587). The proportion of cases among women, injection-drug users, and African Americans also increased as a result of this change in the case definition. The expansion of the case definition may have resulted in a peak or plateau in the AIDS incidence in California because of reporting earlier in the HIV disease progression. The expanded case definition has enhanced the usefulness of AIDS surveillance data for targeting secondary prevention efforts, but more behavioral and HIV serosurveys are still needed to adequately target primary HIV prevention efforts. Images Figure 1. PMID:8775725

  10. A search-free method for calculating the tunings of PID controllers for the minimum of a quadratic criterion

    NASA Astrophysics Data System (ADS)

    Pikina, G. A.; Meshcheryakova, Yu. S.

    2012-10-01

    A new method for calculating the tunings of PID controllers for linear plants with a time delay minimizing the quadratic criterion I 2 is considered. The idea of the proposed method consists in obtaining the complex frequency response of the optimal linear controller followed by approaching to it the complex frequency response of a PID controller in the essential frequency band using the least squares method.

  11. Development of a GA-Fuzzy-Immune PID Controller with Incomplete Derivation for Robot Dexterous Hand

    PubMed Central

    Liu, Xin-hua; Chen, Xiao-hu; Zheng, Xian-hua; Li, Sheng-peng; Wang, Zhong-bin

    2014-01-01

    In order to improve the performance of robot dexterous hand, a controller based on GA-fuzzy-immune PID was designed. The control system of a robot dexterous hand and mathematical model of an index finger were presented. Moreover, immune mechanism was applied to the controller design and an improved approach through integration of GA and fuzzy inference was proposed to realize parameters' optimization. Finally, a simulation example was provided and the designed controller was proved ideal. PMID:25097881

  12. Development of a GA-fuzzy-immune PID controller with incomplete derivation for robot dexterous hand.

    PubMed

    Liu, Xin-hua; Chen, Xiao-hu; Zheng, Xian-hua; Li, Sheng-peng; Wang, Zhong-bin

    2014-01-01

    In order to improve the performance of robot dexterous hand, a controller based on GA-fuzzy-immune PID was designed. The control system of a robot dexterous hand and mathematical model of an index finger were presented. Moreover, immune mechanism was applied to the controller design and an improved approach through integration of GA and fuzzy inference was proposed to realize parameters' optimization. Finally, a simulation example was provided and the designed controller was proved ideal.

  13. Sinusoidal rotatory chair system by an auto-tuning fuzzy PID controller

    SciTech Connect

    Park, H.A.; Cha, I.S.; Baek, H.L.

    1995-12-31

    This paper presents DC servo motor speed control characteristics by fuzzy logic controller and considers position following control response with controller. A sinusoidal rotatory chair system using an auto tuning fuzzy PID control was designed to evaluate the vestibular function. Then the system is investigated for the effects of change by the fuzziness of fuzzy variable. If this system is supported by a channel, it is considered for application in industry of multi joint robot and precision parallel driving.

  14. The Effect of Response Bias on the Personality Inventory for DSM-5 (PID-5).

    PubMed

    McGee Ng, Sarah A; Bagby, R Michael; Goodwin, Brandee E; Burchett, Danielle; Sellbom, Martin; Ayearst, Lindsay E; Dhillon, Sonya; Yiu, Shirley; Ben-Porath, Yossef S; Baker, Spencer

    2016-01-01

    Valid self-report assessment of psychopathology relies on accurate and credible responses to test questions. There are some individuals who, in certain assessment contexts, cannot or choose not to answer in a manner typically representative of their traits or symptoms. This is referred to, most broadly, as test response bias. In this investigation, we explore the effect of response bias on the Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2013 ), a self-report instrument designed to assess the pathological personality traits used to inform diagnosis of the personality disorders in Section III of DSM-5. A set of Minnesota Multiphasic Personality Inventory Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 / 2011 ) validity scales, which are used to assess and identify response bias, were employed to identify individuals who engaged in either noncredible overreporting (OR) or underreporting (UR), or who were deemed to be reporting or responding to the items in a "credible" manner-credible responding (CR). A total of 2,022 research participants (1,587 students, 435 psychiatric patients) completed the MMPI-2-RF and PID-5; following protocol screening, these participants were classified into OR, UR, or CR response groups based on MMPI-2-RF validity scale scores. Groups of students and patients in the OR group scored significantly higher on the PID-5 than those students and patients in the CR group, whereas those in the UR group scored significantly lower than those in the CR group. Although future research is needed to explore the effects of response bias on the PID-5, results from this investigation provide initial evidence suggesting that response bias influences scale elevations on this instrument.

  15. An adaptive PID like controller using mix locally recurrent neural network for robotic manipulator with variable payload.

    PubMed

    Sharma, Richa; Kumar, Vikas; Gaur, Prerna; Mittal, A P

    2016-05-01

    Being complex, non-linear and coupled system, the robotic manipulator cannot be effectively controlled using classical proportional-integral-derivative (PID) controller. To enhance the effectiveness of the conventional PID controller for the nonlinear and uncertain systems, gains of the PID controller should be conservatively tuned and should adapt to the process parameter variations. In this work, a mix locally recurrent neural network (MLRNN) architecture is investigated to mimic a conventional PID controller which consists of at most three hidden nodes which act as proportional, integral and derivative node. The gains of the mix locally recurrent neural network based PID (MLRNNPID) controller scheme are initialized with a newly developed cuckoo search algorithm (CSA) based optimization method rather than assuming randomly. A sequential learning based least square algorithm is then investigated for the on-line adaptation of the gains of MLRNNPID controller. The performance of the proposed controller scheme is tested against the plant parameters uncertainties and external disturbances for both links of the two link robotic manipulator with variable payload (TL-RMWVP). The stability of the proposed controller is analyzed using Lyapunov stability criteria. A performance comparison is carried out among MLRNNPID controller, CSA optimized NNPID (OPTNNPID) controller and CSA optimized conventional PID (OPTPID) controller in order to establish the effectiveness of the MLRNNPID controller.

  16. A conformal mapping based fractional order approach for sub-optimal tuning of PID controllers with guaranteed dominant pole placement

    NASA Astrophysics Data System (ADS)

    Saha, Suman; Das, Saptarshi; Das, Shantanu; Gupta, Amitava

    2012-09-01

    A novel conformal mapping based fractional order (FO) methodology is developed in this paper for tuning existing classical (Integer Order) Proportional Integral Derivative (PID) controllers especially for sluggish and oscillatory second order systems. The conventional pole placement tuning via Linear Quadratic Regulator (LQR) method is extended for open loop oscillatory systems as well. The locations of the open loop zeros of a fractional order PID (FOPID or PIλDμ) controller have been approximated in this paper vis-à-vis a LQR tuned conventional integer order PID controller, to achieve equivalent integer order PID control system. This approach eases the implementation of analog/digital realization of a FOPID controller with its integer order counterpart along with the advantages of fractional order controller preserved. It is shown here in the paper that decrease in the integro-differential operators of the FOPID/PIλDμ controller pushes the open loop zeros of the equivalent PID controller towards greater damping regions which gives a trajectory of the controller zeros and dominant closed loop poles. This trajectory is termed as "M-curve". This phenomena is used to design a two-stage tuning algorithm which reduces the existing PID controller's effort in a significant manner compared to that with a single stage LQR based pole placement method at a desired closed loop damping and frequency.

  17. Position control of nonlinear hydraulic system using an improved PSO based PID controller

    NASA Astrophysics Data System (ADS)

    Ye, Yi; Yin, Chen-Bo; Gong, Yue; Zhou, Jun-jing

    2017-01-01

    This paper addresses the position control of valve-controlled cylinder system employed in hydraulic excavator. Nonlinearities such as dead zone, saturation, discharge coefficient and friction existed in the system are highlighted during the mathematical modeling. On this basis, simulation model is established and then validated against experiments. Aim for achieving excellent position control performances, an improved particle swarm optimization (PSO) algorithm is presented to search for the optimal proportional-integral-derivative (PID) controller gains for the nonlinear hydraulic system. The proposed algorithm is a hybrid based on the standard PSO algorithm but with the addition of selection and crossover operators from genetic algorithm in order to enhance the searching efficiency. Furthermore, a nonlinear decreasing scheme for the inertia weight of the improved PSO algorithm is adopted to balance global exploration and local exploration abilities of particles. Then a co-simulation platform combining the simulation model with the improved PSO tuning based PID controller is developed. Comparisons of the improved PSO, standard PSO and Phase Margin (PM) tuning methods are carried out with three position references as step signal, ramp signal and sinusoidal wave using the co-simulation platform. The results demonstrated that the improved PSO algorithm can perform well in PID control for positioning of nonlinear hydraulic system.

  18. Optimized linear motor and digital PID controller setup used in Mössbauer spectrometer

    NASA Astrophysics Data System (ADS)

    Kohout, Pavel; Kouřil, Lukáš; Navařík, Jakub; Novák, Petr; Pechoušek, Jiří

    2014-10-01

    Optimization of a linear motor and digital PID controller setup used in a Mössbauer spectrometer is presented. Velocity driving system with a digital PID feedback subsystem was developed in the LabVIEW graphical environment and deployed on the sbRIO real-time hardware device (National Instruments). The most important data acquisition processes are performed as real-time deterministic tasks on an FPGA chip. Velocity transducer of a double loudspeaker type with a power amplifier circuit is driven by the system. Series of calibration measurements were proceeded to find the optimal setup of the P, I, D parameters together with velocity error signal analysis. The shape and given signal characteristics of the velocity error signal are analyzed in details. Remote applications for controlling and monitoring the PID system from computer or smart phone, respectively, were also developed. The best setup and P, I, D parameters were set and calibration spectrum of α-Fe sample with an average nonlinearity of the velocity scale below 0.08% was collected. Furthermore, the width of the spectral line below 0.30 mm/s was observed. Powerful and complex velocity driving system was designed.

  19. Stabilizing PID controllers for a single-link biomechanical model with position, velocity, and force feedback.

    PubMed

    Iqbal, Kamran; Roy, Anindo

    2004-12-01

    In this paper we address the problem of PID stabilization of a single-link inverted pendulum-based biomechanical model with force feedback, two levels of position and velocity feedback, and with delays in all the feedback loops. The novelty of the proposed model lies in its physiological relevance, whereby both small and medium latency sensory feedbacks from muscle spindle (MS), and force feedback from Golgi tendon organ (GTO) are included in the formulation. The biomechanical model also includes active and passive viscoelastic feedback from Hill-type muscle model and a second-order low-pass function for muscle activation. The central nervous system (CNS) regulation of postural movement is represented by a proportional-integral-derivative (PID) controller. Padé approximation of delay terms is employed to arrive at an overall rational transfer function of the biomechanical model. The Hermite-Biehler theorem is then used to derive stability results, leading to the existence of stabilizing PID controllers. An algorithm for selection of stabilizing feedback gains is developed using the linear matrix inequality (LMI) approach.

  20. Active vibration and noise control of vibro-acoustic system by using PID controller

    NASA Astrophysics Data System (ADS)

    Li, Yunlong; Wang, Xiaojun; Huang, Ren; Qiu, Zhiping

    2015-07-01

    Active control simulation of the acoustic and vibration response of a vibro-acoustic cavity of an airplane based on a PID controller is presented. A full numerical vibro-acoustic model is developed by using an Eulerian model, which is a coupled model based on the finite element formulation. The reduced order model, which is used to design the closed-loop control system, is obtained by the combination of modal expansion and variable substitution. Some physical experiments are made to validate and update the full-order and the reduced-order numerical models. Optimization of the actuator placement is employed in order to get an effective closed-loop control system. For the controller design, an iterative method is used to determine the optimal parameters of the PID controller. The process is illustrated by the design of an active noise and vibration control system for a cavity structure. The numerical and experimental results show that a PID-based active control system can effectively suppress the noise inside the cavity using a sound pressure signal as the controller input. It is also possible to control the noise by suppressing the vibration of the structure using the structural displacement signal as the controller input. For an airplane cavity structure, considering the issue of space-saving, the latter is more suitable.

  1. PID temperature controller in pig nursery: improvements in performance, thermal comfort, and electricity use.

    PubMed

    de Souza Granja Barros, Juliana; Rossi, Luiz Antonio; Sartor, Karina

    2016-08-01

    The use of smarter temperature control technologies in heating systems can optimize the use of electric power and performance of piglets. Two control technologies of a resistive heating system were assessed in a pig nursery: a PID (proportional, integral, and derivative) controller and a thermostat. The systems were evaluated regarding thermal environment, piglet performance, and use of electric power for 99 days. The heating system with PID controller improved the thermal environment conditions and was significantly (P < 0.001) more efficient in terms of electricity use to produce 1 kg of body weight (2.88 kWh kg(-1)), specific cost (0.75 R$ kg(-1)), weight gain (7.3 kg), daily weight gain (0.21 kg day(-1)), and feed conversion (1.71) than the system with thermostat (3.98 kWh kg(-1); 1.03 R$ kg(-1); 5.2 kg; 0.15 kg day(-1), and 2.62, respectively). The results indicate that the PID-controlled heating system is more efficient in electricity use and provides better conditions for thermal comfort and animal performance than heating with thermostat.

  2. PID temperature controller in pig nursery: improvements in performance, thermal comfort, and electricity use

    NASA Astrophysics Data System (ADS)

    de Souza Granja Barros, Juliana; Rossi, Luiz Antonio; Sartor, Karina

    2016-08-01

    The use of smarter temperature control technologies in heating systems can optimize the use of electric power and performance of piglets. Two control technologies of a resistive heating system were assessed in a pig nursery: a PID (proportional, integral, and derivative) controller and a thermostat. The systems were evaluated regarding thermal environment, piglet performance, and use of electric power for 99 days. The heating system with PID controller improved the thermal environment conditions and was significantly ( P < 0.001) more efficient in terms of electricity use to produce 1 kg of body weight (2.88 kWh kg-1), specific cost (0.75 R kg-1), weight gain (7.3 kg), daily weight gain (0.21 kg day-1), and feed conversion (1.71) than the system with thermostat (3.98 kWh kg-1; 1.03 R kg-1; 5.2 kg; 0.15 kg day-1, and 2.62, respectively). The results indicate that the PID-controlled heating system is more efficient in electricity use and provides better conditions for thermal comfort and animal performance than heating with thermostat.

  3. AtPID: a genome-scale resource for genotype–phenotype associations in Arabidopsis

    PubMed Central

    Lv, Qi; Lan, Yiheng; Shi, Yan; Wang, Huan; Pan, Xia; Li, Peng; Shi, Tieliu

    2017-01-01

    AtPID (Arabidopsis thaliana Protein Interactome Database, available at http://www.megabionet.org/atpid) is an integrated database resource for protein interaction network and functional annotation. In the past few years, we collected 5564 mutants with significant morphological alterations and manually curated them to 167 plant ontology (PO) morphology categories. These single/multiple-gene mutants were indexed and linked to 3919 genes. After integrated these genotype–phenotype associations with the comprehensive protein interaction network in AtPID, we developed a Naïve Bayes method and predicted 4457 novel high confidence gene-PO pairs with 1369 genes as the complement. Along with the accumulated novel data for protein interaction and functional annotation, and the updated visualization toolkits, we present a genome-scale resource for genotype–phenotype associations for Arabidopsis in AtPID 5.0. In our updated website, all the new genotype–phenotype associations from mutants, protein network, and the protein annotation information can be vividly displayed in a comprehensive network view, which will greatly enhance plant protein function and genotype–phenotype association studies in a systematical way. PMID:27899679

  4. PID tuning rules for SOPDT systems: review and some new results.

    PubMed

    Panda, Rames C; Yu, Cheng-Ching; Huang, Hsiao-Ping

    2004-04-01

    PID controllers are widely used in industries and so many tuning rules have been proposed over the past 50 years that users are often lost in the jungle of tuning formulas. Moreover, unlike PI control, different control laws and structures of implementation further complicate the use of the PID controller. In this work, five different tuning rules are taken for study to control second-order plus dead time systems with wide ranges of damping coefficients and dead time to time constant ratios (D/tau). Four of them are based on IMC design with different types of approximations on dead time and the other on desired closed-loop specifications (i.e., specified forward transfer function). The method of handling dead time in the IMC type of design is important especially for systems with large D/tau ratios. A systematic approach was followed to evaluate the performance of controllers. The regions of applicability of suitable tuning rules are highlighted and recommendations are also given. It turns out that IMC designed with the Maclaurin series expansion type PID is a better choice for both set point and load changes for systems with D/tau greater than 1. For systems with D/tau less than 1, the desired closed-loop specification approach is favored.

  5. 78 FR 33848 - Draft Guidance for Industry on Human Immunodeficiency Virus-1 Infection: Developing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-05

    ... No. FDA-2013-D-0589] Draft Guidance for Industry on Human Immunodeficiency Virus-1 Infection... guidance for industry entitled ``Human Immunodeficiency Virus-1 Infection: Developing Antiretroviral Drugs... guidance for industry entitled ``Human Immunodeficiency Virus-1 Infection: Developing Antiretroviral...

  6. A new method for direct total OH reactivity measurements using a fast Gas Chromatographic Photo-Ionization Detector (GC-PID)

    NASA Astrophysics Data System (ADS)

    Nölscher, A. C.; Sinha, V.; Bockisch, S.; Klüpfel, T.; Williams, J.

    2012-04-01

    The primary and most important oxidant in the troposphere is the hydroxyl radical (OH). Currently the atmospheric sinks of OH are poorly constrained. One way to characterize the overall sink term of OH is to measure directly the ambient loss rate of OH, the total OH reactivity. The first direct measurements of total OH reactivity were performed using laser induced fluorescence (LIF) [1], [2]. Recently a new method for determining OH reactivity was developed called the comparative reactivity method (CRM) [3]. The measurement principle is based on a competitive reaction between a reactive molecule not normally present in air with OH, and atmospheric OH reactive molecules with OH. The reactive molecule (X), is passed through a Teflon coated glass reactor and its concentration is monitored with a suitable detector. OH radicals are then introduced into the reactor at a constant rate to react with X, first in the presence of zero air and then in the presence of ambient air containing OH reactive species. Comparing the amount of X exiting the reactor with and without the competing ambient air molecules directly provides the atmospheric total OH reactivity. In the first version of this set up, molecule X is pyrrole (C5H4N) and the detector used is a proton transfer reaction mass spectrometer (PTR-MS). In comparison to the original LIF based system, the PTR-MS has the advantage of being smaller, less expensive, and commercially available. However, using the PTR-MS for total OH reactivity measurements prevents it from probing the broad variety of volatile organic compounds in ambient air. Moreover, even smaller, less expensive and more portable detectors are available. This work examines the potential for a GC-PID in order to make the total OH reactivity measurement accessible to more practitioners. This study presents measurements of total OH reactivity with a custom built GC-PID (VOC-Analyzer from IUT-Berlin, now ENIT (Environics-IUT GmbH))[4]. The GC-PID is small (260

  7. Lymphatic Dissemination of Simian Immunodeficiency Virus after Penile Inoculation

    PubMed Central

    Ma, Zhong-Min; Dutra, Joseph; Fritts, Linda

    2016-01-01

    ABSTRACT The human immunodeficiency virus (HIV) is primarily transmitted by heterosexual contact, and approximately equal numbers of men and women worldwide are infected with the virus. Understanding the biology of HIV acquisition and dissemination in men exposed to the virus by insertive penile intercourse is likely to help with the rational design of vaccines that can limit or prevent HIV transmission. To characterize the target cells and dissemination pathways involved in establishing systemic simian immunodeficiency virus (SIV) infection, we necropsied male rhesus macaques at 1, 3, 7, and 14 days after penile SIV inoculation and quantified the levels of unspliced SIV RNA and spliced SIV RNA in tissue lysates and the number of SIV RNA-positive cells in tissue sections. We found that penile (glans, foreskin, coronal sulcus) T cells and, to a lesser extent, macrophages and dendritic cells are primary targets of infection and that SIV rapidly reaches the regional lymph nodes. At 7 days after inoculation, SIV had disseminated to the blood, systemic lymph nodes, and mucosal lymphoid tissues. Further, at 7 days postinoculation (p.i.), spliced SIV RNA levels were the highest in the genital lymph nodes, indicating that this is the site where the infection is initially amplified. By 14 days p.i., spliced SIV RNA levels were high in all tissues, but they were the highest in the gastrointestinal tract, indicating that the primary site of virus replication had shifted from the genital lymph nodes to the gut. The stepwise pattern of virus replication and dissemination described here suggests that vaccine-elicited immune responses in the genital lymph nodes could help prevent infection after penile SIV challenge. IMPORTANCE To be the most effective, vaccines should produce antiviral immune responses in the anatomic sites of virus replication. Thus, understanding the path taken by HIV from the mucosal surfaces, which are the site of virus exposure, to the deeper tissues where

  8. Human Immunodeficiency Virus-1 (HIV-1)

    DTIC Science & Technology

    1991-03-19

    Immunodeficiency Virus (HIV)," September 11, 1987 (hereby canceled) 1d) Assistant Secretary of Defense (Health Affairs) Memorandum, ’) "The DoD HTLV -III...Testing Blood and Plasma for Antibodies to HTLV -III," July 17, 1985 (hereby canceled) (f) DoD Instruction 1438.4, "Compliance with Host Nation Human...partial or complete cutaneous anergy. In staging, if the CD4 number is 400 cells per mm3 , or greater, the individual shall be placed in stage 1 or 2

  9. Screening for severe combined immunodeficiency in neonates

    PubMed Central

    Kelly, Brian T; Tam, Jonathan S; Verbsky, James W; Routes, John M

    2013-01-01

    Severe combined immunodeficiency (SCID) is a rare disease that severely affects the cellular and humoral immune systems. Patients with SCID present with recurrent or severe infections and often with chronic diarrhea and failure to thrive. The disease is uniformly fatal, making early diagnosis essential. Definitive treatment is hematopoietic stem cell transplantation, with best outcomes prior to 3.5 months of age. Newborn screening for SCID using the T-cell receptor excision circle assay has revolutionized early identification of infants with SCID or severe T-cell lymphopenia. PMID:24068875

  10. Molecular Epidemiology of Human Immunodeficiency Virus

    PubMed Central

    2017-01-01

    During the evolution of human immunodeficiency virus (HIV), transmissions between humans and primates resulted in multiple HIV lineages in humans. This evolution has been rapid, giving rise to a complex classification and allowing for worldwide spread and intermixing of subtypes, which has consequently led to dozens of circulating recombinant forms. In the Republic of Korea, 12,522 cases of HIV infection have been reported between 1985, when AIDS was first identified, and 2015. This review focuses on the evolution of HIV infection worldwide and the molecular epidemiologic characteristics of HIV in Korea. PMID:28332348

  11. Primate immunodeficiency virus classification and nomenclature: Review.

    PubMed

    Foley, Brian T; Leitner, Thomas; Paraskevis, Dimitrios; Peeters, Martine

    2016-12-01

    The International Committee for the Taxonomy and Nomenclature of Viruses does not rule on virus classifications below the species level. The definition of species for viruses cannot be clearly defined for all types of viruses. The complex and interesting epidemiology of Human Immunodeficiency Viruses demands a detailed and informative nomenclature system, while at the same time it presents challenges such that many of the rules need to be flexibly applied or modified over time. This review outlines the nomenclature system for primate lentiviruses and provides an update on new findings since the last review was written in 2000.

  12. [Acquired immunodeficiency syndrome in pediatric patients].

    PubMed

    Molina Moguel, J L; Ruiz Illezcas, R; Forsbach Sánchez, S; Carreño Alvarez, S; Picco Díaz, I

    1990-12-01

    The object of this study was to determine how many of the patients treated at the Pediatric Odontology Clinic, a branch of the Maxillo-Facial Surgery Service at the Veinte de Noviembre Regional Hospital, ISSSTE, are VIH-positive of show serious manifestations of Acquired Immuno-Deficiency Syndrome (AIDS). For such purpose, 100 pediatric patients suffering from different systemic or local diseases were evaluated, the most common being hematological alterations. Results evidenced the presence of VIH in the blood of five of the pediatric subjects, all suffering from Hemophilia.

  13. Primate immunodeficiency virus classification and nomenclature: Review

    SciTech Connect

    Foley, Brian T.; Leitner, Thomas; Paraskevis, Dimitrios; Peeters, Martine

    2016-10-24

    The International Committee for the Taxonomy and Nomenclature of Viruses does not rule on virus classifications below the species level. The definition of species for viruses cannot be clearly defined for all types of viruses. The complex and interesting epidemiology of Human Immunodeficiency Viruses demands a detailed and informative nomenclature system, while at the same time it presents challenges such that many of the rules need to be flexibly applied or modified over time. As a result, this review outlines the nomenclature system for primate lentiviruses and provides an update on new findings since the last review was written in 2000.

  14. Primate immunodeficiency virus classification and nomenclature: Review

    DOE PAGES

    Foley, Brian T.; Leitner, Thomas; Paraskevis, Dimitrios; ...

    2016-10-24

    The International Committee for the Taxonomy and Nomenclature of Viruses does not rule on virus classifications below the species level. The definition of species for viruses cannot be clearly defined for all types of viruses. The complex and interesting epidemiology of Human Immunodeficiency Viruses demands a detailed and informative nomenclature system, while at the same time it presents challenges such that many of the rules need to be flexibly applied or modified over time. As a result, this review outlines the nomenclature system for primate lentiviruses and provides an update on new findings since the last review was written inmore » 2000.« less

  15. Pelvic inflammatory disease increases the risk of a second primary malignancy in patients with cervical cancer treated by surgery alone.

    PubMed

    Chiou, Wen-Yen; Chen, Chien-An; Lee, Moon-Sing; Lin, Hon-Yi; Li, Chung-Yi; Su, Yu-Chieh; Tsai, Shiang-Jiun; Hung, Shih-Kai

    2016-11-01

    As the number of long-term cervical cancer survivors continues to increase because of improvements in treatment, concerns about second primary malignancy have grown. The high-risk area of second primary cancers in cervical cancer survivors is the pelvis. Pelvic inflammatory disease (PID) could be a useful marker for gynecological cancers. Thus, we designed a large-scale, nationwide, controlled cohort study to investigate whether PID or other risk factors increased the risk of second primary cancers in patients with cervical cancer treated by surgery alone.Between 2000 and 2010, a total of 24,444 cervical cancer patients were identified using the Registry Data for Catastrophic Illness and the National Health Insurance Research Database (NHIRD) of Taiwan. Patients who received definite surgery were selected. To exclude the effect on second primary malignancy by treatment modalities, all cervical patients who ever having received adjuvant or definite radiotherapy or chemotherapy for primary cervical cancer were excluded. Finally, 3860 cervical cancer patients treated by surgery alone without adjuvant treatments were analyzed.Cox proportional hazards model was used for multivariate analysis and the Kaplan-Meier method was used to assess the cumulative risks. Regarding the incidence of second primary cancers, the standardized incidence ratio (SIR) was used.The median follow-up time was 56.6 months. The 6-year cumulative risk of second primary cancers is 0.16% and 0.12% for PID and without PID, respectively. After adjustment for confounders, age of less than 50 years, the presence of diabetes mellitus, and PID were significantly positivity associated with the risk of second primary cancers. The hazard ratios (HRs) of age less than 50 years, diabetes mellitus, and PID were 1.38 (95% CI = 1.11-2.04), 1.40 (95% CI = 1.06-1.85), and 1.35 (95% CI = 1.00-1.81), respectively. A higher incidence of second primary cancers was observed in the genitals, bladder, and

  16. Tinea imbricata as a clue to occult immunodeficiency.

    PubMed

    Maroñas Jiménez, Lidia; Monsálvez, Verónica; Gutiérrez García-Rodrigo, Carlota; Postigo Llorente, Concepción

    2014-01-01

    Tinea imbricata (TI) is a geographically restricted dermatophytosis with distinctive clinical and immunologic features. We present a case of TI occurring in a native Brazilian child with previously undiagnosed human immunodeficiency virus infection. Physicians should bear in mind that diagnosis of TI may be a clinical clue to potentially serious underlying immunodeficiency.

  17. 45 CFR 96.128 - Requirements regarding human immunodeficiency virus.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Requirements regarding human immunodeficiency virus. 96.128 Section 96.128 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... human immunodeficiency virus. (a) In the case of a designated State as described in paragraph (b)...

  18. 45 CFR 96.128 - Requirements regarding human immunodeficiency virus.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Requirements regarding human immunodeficiency virus. 96.128 Section 96.128 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... human immunodeficiency virus. (a) In the case of a designated State as described in paragraph (b)...

  19. Common variable immunodeficiency diagnosed during the treatment of bronchial asthma: Unusual cause of wheezing

    PubMed Central

    Akaba, Tomohiro; Kondo, Mitsuko; Toriyama, Midori; Kubo, Ayako; Hara, Kaori; Yamada, Takeshi; Yoshinaga, Kentaro; Tamaoki, Jun

    2015-01-01

    Common variable immunodeficiency (CVID) is the most frequent primary immunodeficiency in adults and children. We herein report a case of CVID, who was misdiagnosed with asthma due to wheezing episodes and relatively late onset. A 51-year-old woman had suffered from recurrent upper and lower airway infection for recent 2 years. She repeated wheezing attacks and was treated as asthma exacerbation triggered by infection. She was referred to our hospital for investigation and treatment. Lung function tests showed no reversibility of FEV1 by β-adrenergic agonist, but the increase of V50/V25. Chest CT showed slight to moderate bronchial wall thickening and bronchiectasis. After that, she suffered from pneumonia with wheezing attacks twice a month, and immunodeficiency was strongly suspected. Her blood tests showed marked decreases of all classes of immunoglobulin and nearly lack of memory B cells, NKT cells and plasmacytoid dendritic cells. She was diagnosed with CVID, and was treated with replacement of gammaglobulin. Thereafter, her wheezing episodes with infection were remarkably improved. Because the delay of diagnosis with CVID likely causes poor mortality and morbidity, a possibility of CVID should be considered in patients with frequent asthma-like symptoms due to recurrent airway infection. PMID:26744651

  20. New genetic discoveries and primary immune deficiencies.

    PubMed

    Hernandez-Trujillo, Vivian

    2014-04-01

    The field of immunology has undergone recent discoveries of genetic causes for many primary immunodeficiency diseases (PIDD). The ever-expanding knowledge has led to increased understanding behind the pathophysiology of these diseases. Since these diseases are rare, the patients are frequently misdiagnosed early in the presentation of their illnesses. The identification of new genes has increased our opportunities for recognizing and making the diagnosis in patients with PIDD before they succumb to infections that may result secondary to their PIDD. Some mutations lead to a variety of presentations of severe combined immunodeficiency (SCID). The myriad and ever-growing genetic mutations which lead to SCID phenotypes have been identified in recent years. Other mutations associated with some genetic syndromes have associated immunodeficiency and are important for making the diagnosis of primary immunodeficiency in patients with some syndromes, who may otherwise be missed within the larger context of their syndromes. A variety of mutations also lead to increased susceptibility to infections due to particular organisms. These patterns of infections due to specific organisms are important keys in properly identifying the part of the immune system which is affected in these patients. This review will discuss recent genetic discoveries that enhance our understanding of these complex diseases.

  1. [Thoracic manifestations of AIDS (acquired immunodeficiency syndrome)].

    PubMed

    Bernasconi, A; Zompatori, M; Chiodo, F; Costigliola, P; Ricchi, E; Colangeli, V; Canini, R; Gavelli, G

    1989-11-01

    AIDS (acquired immunodeficiency syndrome) seems to be related to human immunodeficiency virus (HIV) and is characterized by severe T-helpers lymphocyte dysfunction. Many of the AIDS patients (47-70%) develop pulmonary manifestations, both infectious and neoplastic, in the course of their disease. In the Department of Infectious Diseases of our Hospital are studied many patients HIV+. Every year 246 seropositive new patients have been discovered. Among them we have studied 25 subjects with respiratory disease, by chest radiographs; successively, according to clinical picture, we have performed thoracic computed tomography, Gallium scintigraphy, fiberoptic bronchoscopy with transbronchial biopsy (TBB), bronchoalveolar lavage (BAL); the majority of these patients (68%) had AIDS, only 28% had ARC and 4% had PGL. In our experience, the diagnosed diseases were mainly infections (92%), and most frequently (52%) due to Pneumocystis carinii, alone or in association with other etiologic agents. We have not found pathognomonic radiographic abnormalities, but chest X-ray evaluated with clinical and laboratory data, may often be useful to obtain diagnostic indications and in order to determine a more specific and aggressive diagnostic approach.

  2. Human immunodeficiency virus infection in childhood.

    PubMed

    Blokzijl, M L

    1988-03-01

    Acquired immunodeficiency syndrome is associated with considerable morbidity in infants and children. It is caused by human immunodeficiency virus (HIV) which can be transmitted vertically from mother to infant early in pregnancy. Transmission might also occur via breast milk. Although the exact transmission rate of HIV from mother to infant is not known, HIV can become a major threat to child survival. This threat is already present in Africa where high seroprevalences have been reported among infants and young children. Transmission via blood products is decreasing due to reliable methods of screening donors for HIV antibody. Where these tests are not available, parenteral transmission will increase the incidence of HIV infection. The clinical picture of HIV infection in children presents with failure to thrive, pulmonary interstitial pneumonitis, hepatosplenomegaly and recurrent bacterial infections. These are common manifestations of diseases prevalent in children in Africa where malnutrition and recurrent parasitic infections already cause immunosuppression. Recognition of the syndrome is therefore difficult. There is no available cure for HIV infection. Supportive treatment and relief of pain and suffering are the only means of management at present. Prevention of spread of the illness to infants and young children is therefore of paramount importance.

  3. The Acquired Immunodeficiency Syndrome: current status.

    PubMed Central

    Quagliarello, V.

    1982-01-01

    A recently recognized syndrome of acquired immunodeficiency (Acquired Immunodeficiency Syndrome-AIDS) has arisen since June 1981. It has received international attention. The clinical spectrum consists of repeated opportunistic infections, rare malignancies, and autoimmune phenomena, occurring in previously healthy adults with no history of an immunologic disorder. The population subset at risk for this syndrome appears to be predominantly homosexual American males and intravenous drug abusers with rare cases being reported in heterosexuals, hemophiliacs, and foreign patients, especially Haitians. The immunologic aberrancy in all patients described appears limited to T-lymphocyte hyporesponsiveness and imbalance of T-helper and suppressor cells. This disordered immunoregulation is a consistent finding in all reported cases and appears to predispose to the opportunistic infections and malignancies which have been associated with a 40 percent mortality. The underlying factor responsible for the immunoregulatory defect is unknown but possible etiologies include a transmissible infectious agent, drug use, chronic antigen stimulation, and spermatozoa exposure. Treatment of the associated infections and malignancies has been a frustrating endeavor as many patients respond incompletely or relapse soon after successful treatment course. Preventive measures, including patient education, physician awareness, and immunomodulating agents, are discussed. PMID:6134399

  4. Hepatitis C and human immunodeficiency virus coinfections.

    PubMed

    Dodig, M; Tavill, A S

    2001-01-01

    Hepatitis C virus (HCV) has become a major contributor to morbidity and mortality in patients with human immunodeficiency virus (HIV). It is estimated that 30% to 50% of patients with HIV are coinfected with HCV. Advances in antiretroviral therapy and improved life expectancy of HIV patients have resulted in an emergence of HCV-induced liver disease as a leading cause of significant morbidity and death in this population. Clinically, hepatitis C is a more severe disease in HIV-infected individuals, characterized by rapid progression toward end-stage liver disease. Highly active antiretroviral therapy is the mainstay of current acquired immunodeficiency syndrome management. One of the limiting side effects of combination therapy for HIV is hepatotoxicity, which is more common and often more serious in patients with underlying liver disease. Management of coinfected patients has no strict guidelines, but it is generally accepted that HIV infection needs to be treated before HCV. Hepatitis C in coinfected individuals is probably best treated using combination therapy (interferon alpha and ribavirin). It appears that combination therapy can safely be administered to this population and that previous concerns about ribavirin/zidovudine antagonism are unsubstantiated in clinical practice. Although initial results using only interferon alpha showed poor results in HIV coinfected patients, combination therapy seems to be as effective as in the general population. All HIV-HCV coinfected patients should be vaccinated against hepatitis B and hepatitis A; vaccines are safe and effective.

  5. Utility of the Personality Inventory for DSM-5-Brief Form (PID-5-BF) in the Measurement of Maladaptive Personality and Psychopathology.

    PubMed

    Anderson, Jaime L; Sellbom, Martin; Salekin, Randall T

    2016-11-07

    The Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) Personality and Personality Disorders workgroup developed the Personality Inventory for the DSM-5 (PID-5) for the assessment of the alternative trait model for DSM-5 Along with this measure, the American Psychiatric Association published an abbreviated version, the PID-5-Brief form (PID-5-BF). Although this measure is available on the DSM-5 website for use, only two studies have evaluated its psychometric properties and validity and no studies have examined the U.S. version of this measure. The current study evaluated the reliability, factor structure, and construct validity of PID-5-BF scale scores. This included an evaluation of the scales' associations with Section II PDs, a well-validated dimensional measure of personality psychopathology, and broad externalizing and internalizing psychopathology measures. We found support for the reliability of PID-5-BF scales as well as for the factor structure of the measure. Furthermore, a series of correlation and regression analyses showed conceptually expected associations between PID-5-BF and external criterion variables. Finally, we compared the correlations with external criterion measures to those of the full-length PID-5 and PID-5-Short form. Intraclass correlation analyses revealed a comparable pattern of correlations across all three measures, thereby supporting the use of the PID-5-BF as a screening measure of dimensional maladaptive personality traits.

  6. Reliability and validity of the personality inventory for DSM-5 (PID-5): predicting DSM-IV personality disorders and psychopathy in community-dwelling Italian adults.

    PubMed

    Fossati, Andrea; Krueger, Robert F; Markon, Kristian E; Borroni, Serena; Maffei, Cesare

    2013-12-01

    In order to assess the internal consistency, factor structure, and ability to recover DSM-IV personality disorders (PDs) of the Personality Inventory for DSM-5 (PID-5) scales, 710 Italian adult community dwelling volunteers were administered the Italian translation of the PID-5, as well as the Italian translation of the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Cronbach's alpha values were >.70 for all PID-5 facet scales and greater than .90 for all PID-5 domain scales. Parallel analysis and confirmatory factor analysis supported the theoretical five-factor model of the PID-5 trait scales. Regression analyses showed that both PID-5 trait and domain scales explained a substantial amount of variance in the PDQ-4+ PD scales, with the exception of the Passive-Aggressive PD scale. When the PID-5 was administered to a second independent sample of 389 Italian adult community dwelling volunteers, the basic psychometric properties of the scale were replicated. In this second sample, the PID-5 trait and domain scales proved to be significant predictors of psychopathy measures. As a whole, the results of the present study support the hypothesis that the PID-5 is a reliable instrument which is able to recover DSM-IV PDs, as well as to capture personality pathology that is not included in the DSM-IV (namely, psychopathy).

  7. Health Administrator Perspectives on Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Prevention and Services at Historically Black Colleges and Universities

    ERIC Educational Resources Information Center

    Warren-Jeanpiere, Lari; Jones, Sandra; Sutton, Madeline Y.

    2011-01-01

    Objective: Due to the disproportionate impact of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) among African American young adults, the authors explored (1) number of historically black college and university (HBCU) campuses with existing HIV prevention policies and services and (2) perceived barriers for implementing…

  8. [Bilateral cavernous sinus non-Hodgkin's lymphoma as the presenting sign of acquired immunodeficiency syndrome: case report].

    PubMed

    Barreira Junior, Alan Kardec; Moura, Frederico Castelo; Monteiro, Mario Luiz Ribeiro

    2011-01-01

    Case report of bilateral cavernous sinus syndrome due to primary non-Hodgkin lymphoma of the central nervous system in a patient infected by the human immunodeficiency virus. A 51-year-old male patient infected by the human immunodeficiency virus but without antiretroviral treatment developed paralysis of the V and VI cranial nerves. Imaging studies were obtained to investigate an orbital apex and a cavernous sinus syndrome. A computerized tomography scan of the orbit was normal but a high-resolution magnetic resonance imaging demonstrated bilateral enlargement of the cavernous sinus. Although primary lymphoma of the central nervous system is a rare condition, it should be considered in the differential diagnosis in immunocompromised patients who develop ocular motility abnormalities and imaging signs suggestive of infiltrative cavernous sinus lesions.

  9. Focal neurological disease in patients with acquired immunodeficiency syndrome.

    PubMed

    Skiest, Daniel J

    2002-01-01

    Focal neurological disease in patients with acquired immunodeficiency syndrome may be caused by various opportunistic pathogens and malignancies, including Toxoplasma gondii, progressive multifocal leukoencephalopathy (PML), cytomegalovirus (CMV), and Epstein-Barr virus-related primary central nervous system (CNS) lymphoma. Diagnosis may be difficult, because the findings of lumbar puncture, computed tomography (CT), and magnetic resonance imaging are relatively nonspecific. Newer techniques have led to improved diagnostic accuracy of these conditions. Polymerase chain reaction (PCR) of cerebrospinal fluid specimens is useful for diagnosis of PML, CNS lymphoma, and CMV encephalitis. Recent studies have indicated the diagnostic utility of new neuroimaging techniques, such as single-photon emission CT and positron emission tomography. The combination of PCR and neuroimaging techniques may obviate the need for brain biopsy in selected cases. However, stereotactic brain biopsy, which is associated with relatively low morbidity rates, remains the reference standard for diagnosis. Highly active antiretroviral therapy has improved the prognosis of several focal CNS processes, most notably toxoplasmosis, PML, and CMV encephalitis.

  10. Biallelic JAK1 mutations in immunodeficient patient with mycobacterial infection

    PubMed Central

    Eletto, Davide; Burns, Siobhan O.; Angulo, Ivan; Plagnol, Vincent; Gilmour, Kimberly C.; Henriquez, Frances; Curtis, James; Gaspar, Miguel; Nowak, Karolin; Daza-Cajigal, Vanessa; Kumararatne, Dinakantha; Doffinger, Rainer; Thrasher, Adrian J.; Nejentsev, Sergey

    2016-01-01

    Mutations in genes encoding components of the immune system cause primary immunodeficiencies. Here, we study a patient with recurrent atypical mycobacterial infection and early-onset metastatic bladder carcinoma. Exome sequencing identified two homozygous missense germline mutations, P733L and P832S, in the JAK1 protein that mediates signalling from multiple cytokine receptors. Cells from this patient exhibit reduced JAK1 and STAT phosphorylation following cytokine stimulations, reduced induction of expression of interferon-regulated genes and dysregulated cytokine production; which are indicative of signalling defects in multiple immune response pathways including Interferon-γ production. Reconstitution experiments in the JAK1-deficient cells demonstrate that the impaired JAK1 function is mainly attributable to the effect of the P733L mutation. Further analyses of the mutant protein reveal a phosphorylation-independent role of JAK1 in signal transduction. These findings clarify JAK1 signalling mechanisms and demonstrate a critical function of JAK1 in protection against mycobacterial infection and possibly the immunological surveillance of cancer. PMID:28008925

  11. Human immunodeficiency virus, herpes virus infections, and pulmonary vascular disease

    PubMed Central

    Flores, Sonia C.; Almodovar, Sharilyn

    2013-01-01

    The following state-of-the-art seminar was delivered as part of the Aspen Lung Conference on Pulmonary Hypertension and Vascular Diseases held in Aspen, Colorado in June 2012. This paper will summarize the lecture and present results from a nonhuman primate model of infection with Simian (Human) Immunodeficiency Virus - nef chimeric virions as well as the idea that polymorphisms in the HIV-1 nef gene may be driving the immune response that results in exuberant inflammation and aberrant endothelial cell (EC) function. We will present data gathered from primary HIV nef isolates where we tested the biological consequences of these polymorphisms and how their presence in human populations may predict patients at risk for developing this disease. In this article, we also discuss how a dysregulated immune system, in conjunction with a viral infection, could contribute to pulmonary arterial hypertension (PAH). Both autoimmune diseases and some viruses are associated with defects in the immune system, primarily in the function of regulatory T cells. These T-cell defects may be a common pathway in the formation of plexiform lesions. Regardless of the route by which viruses may lead to PAH, it is important to recognize their role in this rare disease. PMID:23662195

  12. Cannabinoid administration attenuates the progression of simian immunodeficiency virus.

    PubMed

    Molina, Patricia E; Winsauer, Peter; Zhang, Ping; Walker, Edith; Birke, Leslie; Amedee, Angela; Stouwe, Curtis Vande; Troxclair, Dana; McGoey, Robin; Varner, Kurt; Byerley, Lauri; LaMotte, Lynn

    2011-06-01

    Δ(9)-Tetrahydrocannabinol (Δ(9)-THC), the primary psychoactive component in marijuana, is FDA approved to ameliorate AIDS-associated wasting. Because cannabinoid receptors are expressed on cells of the immune system, chronic Δ(9)-THC use may impact HIV disease progression. We examined the impact of chronic Δ(9)-THC administration (0.32 mg/kg im, 2 × daily), starting 28 days prior to inoculation with simian immunodeficiency virus (SIV(mac251); 100 TCID(50)/ml, iv), on immune and metabolic indicators of disease during the initial 6 month asymptomatic phase of infection in rhesus macaques. SIV(mac251) inoculation resulted in measurable viral load, decreased lymphocyte CD4(+)/CD8(+) ratio, and increased CD8(+) proliferation. Δ(9)-THC treatment of SIV-infected animals produced minor to no effects in these parameters. However, chronic Δ(9)-THC administration decreased early mortality from SIV infection (p = 0.039), and this was associated with attenuation of plasma and CSF viral load and retention of body mass (p = NS). In vitro, Δ(9)-THC (10 μm) decreased SIV (10 TCID(50)) viral replication in MT4-R5 cells. These results indicate that chronic Δ(9)-THC does not increase viral load or aggravate morbidity and may actually ameliorate SIV disease progression. We speculate that reduced levels of SIV, retention of body mass, and attenuation of inflammation are likely mechanisms for Δ(9)-THC-mediated modulation of disease progression that warrant further study.

  13. Bronchus Associated Lymphoid Tissue Lymphoma Presenting with Immunodeficiency and Multiple Pulmonary Nodules

    PubMed Central

    Ozbalak, Murat; Ersen, Ezel; Akı, Hilal; Cem Ar, Muhlis; Umut, Sema

    2017-01-01

    Bronchus Associated Lymphoid Tissue Lymphoma (BALTOMA) is a rare subgroup of pulmonary non-Hodgkin's lymphomas (NHLs) comprising less than 1% of all cases. It constitutes 3.6% of all extranodal lymphomas and only 0.5–1% of primary pulmonary malignancies. They are usually low grade B-cell lymphomas and are considered to originate from the mucosa associated lymphoid tissue (MALT) of the bronchi. Here, we represent a rare case of BALTOMA presenting with immunodeficiency and multiple pulmonary nodules. PMID:28386504

  14. Human immunodeficiency virus-1 associated nephropathy (HIVAN): epidemiology, pathogenesis, histology, diagnosis, and medical management.

    PubMed

    Lochner, Michelle L; Wolf, Andrea

    2006-01-01

    Human immunodeficiency virus-associated nephropathy (HIVAN) is a very distinct, unique, clinico-pathological syndrome, and a structural type of renal failure that is the most common cause of chronic renal failure in patients who are HIV-seropositive. Early referral and a long-term, primary care approach can improve patient outcomes. Careful adjustments of prescription doses with regularly scheduled, and at times frequent, laboratory testing will yield, optimal health, improve the quality of life, and most importantly, will decrease the incidence of morbidity and mortality in those individuals afflicted with both HIV and HIVAN.

  15. The development and psychometric properties of an informant-report form of the personality inventory for DSM-5 (PID-5).

    PubMed

    Markon, Kristian E; Quilty, Lena C; Bagby, R Michael; Krueger, Robert F

    2013-06-01

    The current article reports on the development, psychometric properties, and external validity of an informant-report form of the Personality Inventory for DSM-5 (the PID-5-IRF). Using data from two nationally representative samples, as well as an elevated-risk community sample, we report on the PID-5-IRF item characteristics, scale properties, superordinate factor structure, and correlations with other measures. The PID-5-IRF replicates the factor structure of the self-report form and has relationships with other measures (including the PID-5 self-report form and a widely used Big Five measure) that are consistent with previous research and theory. We believe that the PID-5-IRF is a useful measure for a number of scenarios, such as when additional sources of information are desired, where informant measures are expected to provide incremental validity over self-report, where relationships or social perception is a focal interest, or when response bias is a salient concern. Areas for future research are also discussed.

  16. Regulation of flow through a T-Shaped open cavity by temperature dependent P, PI, and PID controllers

    NASA Astrophysics Data System (ADS)

    Saha, Sourav; Mojumder, Satyajit; Saha, Sumon

    2016-07-01

    P (proportional), PI (proportional-integral), and PID (proportional-integral-derivative) controllers are popular means of controlling industrial processes. Due to superior response, accuracy, and stable performance, PID controllers are mostly used in control systems. This paper presents a mathematical model and subsequent response analysis regarding regulation of flow in mixed convection through a T-shaped open cavity by temperature dependent controllers. The T-shaped cavity has cold top and hot bottom walls, while air is flowing through the inlet at surrounding temperature. The inflow is regulated by a controlled gate which operates according to the signal received from the controller. Values of proportional gain (kp), integral gain (ki), and derivative gain (kd) are varied to obtain the desired system response and to ensure a stable system with fastest response. At first, only P controller is used and eventually PI and finally PID control scheme is applied for controller tuning. Tuning of different controllers (P, PI, and PID) are carried out systematically based on the reference temperature which is continuously monitored at a certain location inside the cavity. It is found that PID controller performs better than P or PI controller.

  17. Design of an embedded PID controller applied to blood pressure control.

    PubMed

    Ribeiro, Anna G C D; Maitelli, André L; de M Valentim, Ricardo A; Leite, Cicília R M; Soares, Heliana B; de Almeida, Nathalee C; Sizilio, Gláucia R M A; Guerreiro, Ana M G

    2011-01-01

    Some diseases, such as hypertension, require a close control of the patient's blood pressure. This is even more critical when that patient is going through--or has just underwent--a surgical procedure In such situations, reducing blood pressure to normal levels is of paramount importance. Usually, this demanding and time consuming monitoring is done manually by clinical personnel and are subject to mistakes and inconsistent practices. In this paper, we propose a solution to the manual monitoring through the design and implementation of an embedded PID controller to handle blood pressure, integrated to an automated monitoring system to assist in detecting anomalies and to optimize the process of patient care.

  18. PI/PID controller design based on IMC and percentage overshoot specification to controller setpoint change.

    PubMed

    Ali, Ahmad; Majhi, Somanath

    2009-01-01

    In this work, the normalized Internal Model Control (IMC) filter time constant is designed to achieve a specified value of the maximum sensitivity for stable first and second order plus time delay process models, respectively. Since a particular value of the maximum sensitivity results in an almost constant percentage overshoot to controller setpoint change, an empirical relationship between the normalized IMC filter time constant and percentage overshoot is presented. The main advantage of the proposed method is that only a user-defined overshoot is required to design a PI/PID controller. Simulation examples are given to demonstrate the value of the proposed method.

  19. H(infinity) PID controller design for runaway processes with time delay.

    PubMed

    Zhang, Weidong; Xu, Xiaoming

    2002-07-01

    This paper presents an efficient method for designing proportional-integra-derivative (PID) controllers for runaway processes with time delay. The method is developed based on the H(infinity) control theory in frequency domain. The constraints imposed by the internal stability and asymptotic properties of the closed-loop system are first investigated, a new procedure is then developed for analytically designing the controller, and simple design formulas are obtained. It is shown that the new controller can be designed to meet specified time domain performances. Typical design examples are provided to illustrate the proposed method.

  20. Incorporation of fractional-order dynamics into an existing PI/PID DC motor control loop.

    PubMed

    Tepljakov, Aleksei; Gonzalez, Emmanuel A; Petlenkov, Eduard; Belikov, Juri; Monje, Concepción A; Petráš, Ivo

    2016-01-01

    The problem of changing the dynamics of an existing DC motor control system without the need of making internal changes is considered in the paper. In particular, this paper presents a method for incorporating fractional-order dynamics in an existing DC motor control system with internal PI or PID controller, through the addition of an external controller into the system and by tapping its original input and output signals. Experimental results based on the control of a real test plant from MATLAB/Simulink environment are presented, indicating the validity of the proposed approach.