Publications by authors named "Anna Sorensen"

18 Publications

  • Page 1 of 1

Improving Secondary Fracture Prevention After Vertebroplasty: Implementation of a Fracture Liaison Service.

J Am Coll Radiol 2021 Sep 22;18(9):1235-1238. Epub 2021 Jun 22.

Director of Musculoskeletal Ultrasound and Fellowship Director for Musculoskeletal Imaging and Intervention, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address:

Objective: The aim of our study was to evaluate a multidisciplinary fracture liaison service (FLS) to improve osteoporosis treatment and secondary fracture prevention for patients after vertebroplasty.

Methods: A retrospective chart review of consecutive vertebroplasty patients from January 2016 to January 2020. FLS began in December 2016 allowing for before-and-after comparison. Statistical analysis included patient demographics and procedure characteristics. Proportion of patients evaluated by the FLS clinic and treatment modification were evaluated. Opt-in versus opt-out referral strategies were compared. Dual energy x-ray absorptiometry scans or vitamin D levels within 3 months before or after vertebroplasty were assessed. Time to event analysis was used to evaluate secondary fracture occurrence.

Results: There were 137 vertebroplasty patients, 39 before FLS and 98 after FLS, included. Only 15% of all patients were already being treated in a bone health clinic. Of those referred and evaluated by the FLS, 73.0% had their osteoporosis treatment modified. Patients evaluated by the FLS were more likely to have a dual energy x-ray absorptiometry scan or a vitamin D level drawn (P < .001 for both). The opt-out referral was more effective with a 75.0% referral rate (P = .71). Secondary fracture of any kind occurred in 23.4% of all patients. Time to event analysis demonstrated a trend toward a reduced risk of secondary spinal fractures in the fracture prevention group with an adjusted hazard ratio of 0.39 (0.13-1.11, 95% confidence interval).

Discussion: A multidisciplinary FLS can be implemented for patients after vertebroplasty to evaluate osteoporotic risk factors and optimize osteoporosis therapy, both of which are important factors in preventing secondary vertebral fractures.
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http://dx.doi.org/10.1016/j.jacr.2021.06.004DOI Listing
September 2021

A dynamic model for spread of livestock-associated methicillin-resistant Staphylococcus aureus on a pig farm, incorporating bacterial load and human exposure through air.

J Theor Biol 2020 11 11;505:110402. Epub 2020 Jul 11.

Department of Veterinary and Animal Sciences, Copenhagen University, Grønnegårdsvej 8, DK-1870 Frederiksberg, Denmark; National Veterinary Institute, Technical University of Denmark, Kemitorvet 204, DK-2800, Lyngby, Denmark.

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is widely distributed in the pig population in many countries, where its presence is undesirable, because as an opportunistic human pathogen, it poses a threat to human health. At present, there is a lack of knowledge regarding successful methods for eradication of LA-MRSA on a pig farm, which does not involve emptying the farm and culling all pigs. Some studies have reported an association between levels of LA-MRSA in the barn air and LA-MRSA carriage among humans entering or working in the pig barns. Therefore, interventions that are able to reduce the amount of LA-MRSA carried by the pigs and/or the concentration of LA-MRSA in the barn air, might be highly relevant if aiming for reducing the spread of LA-MRSA into the general human population. In the present study, an existing agent-based simulation model for spread of LA-MRSA within a pig herd was extended to also include LA-MRSA load and spread through air. This makes it possible to use the model for studying the air exposure to LA-MRSA for humans entering the pig barns. The model was used for simulating various types of interventions in contaminated herds. At present quantitative data for nasal carriage of LA-MRSA in pigs are sparse, and many knowledge gaps regarding spread of LA-MRSA remain. Thus, our goal of building this model was not to provide exact values for risk reduction, but to avail a model that can be used for studying the effect of various types of interventions mechanistically, once more relevant data become available. Collection of more data on the influence of load is crucial for getting a better understanding of which possible interventions strategies, that might still have some potential in countries, where LA-MRSA has already spread to the majority of the pig population.
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http://dx.doi.org/10.1016/j.jtbi.2020.110402DOI Listing
November 2020

[Orthopaedic treatment of malignant bone tumours in children].

Ugeskr Laeger 2020 02;182(7)

The treatment of malignant bone tumours in children has improved significantly over the past 50 years. Previously, the only curative treatment was amputation, but today the surgical treatment has changed towards limb salvage surgery. However, there is not consensus regarding choice of surgical procedure, and it is mainly based upon the surgeon's previous experience. This review describes four reconstructive methods: rotationplasty, free vascularised fibula graft, bone transport and expandable endoprosthesis. All four methods are suitable surgical options with satisfactory functional outcome, though they vary in complications and revision rates.
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February 2020

upd(20)mat is a rare cause of the Silver-Russell-syndrome-like phenotype: Two unrelated cases and screening of large cohorts.

Clin Genet 2020 06 11;97(6):902-907. Epub 2020 Mar 11.

Department of Clinical Genetics, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark.

Silver-Russell syndrome (SRS) is an imprinting disorder characterized by prenatal and postnatal growth retardation, relative macrocephaly, feeding difficulties and body asymmetry. Recently, upd(20)mat has been identified in few patients with SRS-like features, suggestive of a new imprinting disorder characterized by prenatal and postnatal growth failure. Here, we describe two male patients with upd(20) and feeding difficulties, prenatal and postnatal growth retardation and normal cognitive development. During pregnancy, confined placental mosaicism for trisomy 20 was detected in one of the patients but was not investigated further until identification of upd(20)mat in the neonatal period. To evaluate whether upd(20)mat should be part of the first trier genetic diagnostic in patients with growth retardation, we screened a large cohort of patients (n = 673) referred to our laboratories for SRS-testing without detecting any upd(20). Our results, along with the existing evidence, indicate that upd(20)mat is a very rare cause of growth retardation, but should be followed up when confined placental mosaicism for trisomy 20 mosaicism is observed during pregnancy.
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http://dx.doi.org/10.1111/cge.13727DOI Listing
June 2020

Readiness for delivering early palliative care: A survey of primary care and specialised physicians.

Palliat Med 2020 01 18;34(1):114-125. Epub 2019 Dec 18.

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Background: Evidence supporting early palliative care is based on trials of specialised palliative care, but a more sustainable model might involve mainly primary providers.

Aim: The aim of this study was to compare the characteristics of physicians providing primary and specialised palliative care, their attitudes towards early palliative care and their perception of having sufficient resources for its provision.

Design: Survey distributed by mail and e-mail. Specialised providers were defined as both receiving palliative care referrals from other physicians and not providing palliative care only for their own patients.

Setting/participants: A total of 531 physicians providing palliative care in Canada (71% participation) participated in the study.

Results: Of the participants, 257 (48.4%) provided specialised and 274 (51.6%) primary care. Specialists were more likely to have palliative care training (71.8% vs 35.2%), work in urban areas (94.1% vs 75.6%), academic centres (47.8% vs 26.0%) and on teams (82.4% vs 16.8%), and to provide mainly cancer care (84.4% vs 65.1%) (all  < 0.001). Despite strongly favouring early palliative care, only half in each group agreed they had resources to deliver it; agreement was stronger among family physicians, those working on teams and those with greater availability of community and psychosocial support. Primary providers were more likely to agree that renaming the specialty 'supportive care' would increase patient comfort with early palliative care referral (47.4% vs 35.5%,  < 0.001).

Conclusion: Despite strongly favouring the concept, both specialists and primary providers lack resources to deliver early palliative care; its provision may be facilitated by team-based care with appropriate support. Opinions differ regarding the value of renaming palliative care.
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http://dx.doi.org/10.1177/0269216319876915DOI Listing
January 2020

Practices and opinions of specialized palliative care physicians regarding early palliative care in oncology.

Support Care Cancer 2020 Feb 4;28(2):877-885. Epub 2019 Jun 4.

Department of Supportive Care, Princess Margaret Cancer Centre, 610 University Ave., 16-712, Toronto, Ontario, M5G 2M9, Canada.

Purpose: To describe the practices and opinions of specialized palliative care (SPC) physicians regarding early palliative care for patients with cancer, determine characteristics associated with receiving early referrals; and solicit opinions regarding renaming the specialty "supportive care."

Methods: The survey was distributed by mail and e-mail to physicians who had previously self-identified as providing palliative care. SPC physicians were defined as receiving palliative care referrals from other physicians and not providing palliative care only for their own patients.

Results: The response rate was 71% (531/746), of whom 257 (48.4%) practiced SPC. Of these SPC physicians, 84% provided mainly cancer care; > 90% supported early palliative care referral in oncology and had referral criteria facilitating this, but only 20% received early referrals (> 6-month prognosis). There was ambivalence regarding caring for patients with full resuscitation status and responsibility for managing cancer treatment-related complications. SPC physicians receiving early referrals were more likely to be female (p = 0.02) and have a postgraduate degree (p = 0.02), and less likely to provide mainly cancer care (p = 0.03) and to agree that patients should stop chemotherapy before referral (p = 0.009). Although 60% agreed that patients perceive the term "palliative care" negatively and 39% believed a name change to supportive care would encourage early referral, only 21% supported renaming the specialty.

Conclusions: Although most SPC physicians supported early palliative care in oncology, the timing of referrals was often late, and was associated with characteristics of SPC physicians. Few SPC physicians supported renaming palliative care.
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http://dx.doi.org/10.1007/s00520-019-04876-0DOI Listing
February 2020

Risk factors for the occurrence of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in Danish pig herds.

Prev Vet Med 2018 Nov 28;159:22-29. Epub 2018 Aug 28.

National Veterinary Institute, Technical University of Denmark, Kemitorvet 204, DK-2800 Kgs. Lyngby, Denmark.

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is widespread in many European countries including Denmark, where 88% of randomly selected production herds tested positive in 2016. In the present study, we investigated herd-level risk factors for farms being classified as LA-MRSA positive (study 1), in addition to herd-level risk factors for farms changing status from LA-MRSA negative to LA-MRSA positive during a 2-year period (study 2). Risk factors previously identified in other studies were confirmed in study 1: large herd size, herd type (lower risk in herds with sows) and number of pig suppliers. Due to the effect of herd type, data from sow herds (N = 41) and herds without sows (N = 166) were analysed separately. A univariable analysis found that the variables significantly associated with LA-MRSA status for sow herds were: use of wet feed in the sow units; higher weights of piglets at weaning; availability of a delivery room on the farm; cleaning of aisles after pigs were moved; number of pigs per weaner section; number of pigs purchased in the past year, and factors related to rodent control and human traffic in the herd. In herds without sows, the univariable analysis showed that the presence of other species of animal on the farm; negative pressure ventilation; full sectioning; frequent visits from the veterinarian; peroral use of tetracyclines for weaners; number of pigs purchased in the past year, and factors related to rodent control and human traffic in the herd were significantly associated with LA-MRSA status. For herds that changed from LA-MRSA negative to positive (study 2), having a company contract for mouse control, having more than one pig supplier and using group medication in the drinking water were the variables associated with LA-MRSA status in the univariable analysis. We did not succeed in building a biologically meaningful multivariable model based on any of the datasets and, as observed in similar studies, many of the risk factors identified in the univariable analysis were related to herd size. It was therefore not possible to determine whether it was the size of the herd or related factors that were the causal risk factors for being LA-MRSA positive.
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http://dx.doi.org/10.1016/j.prevetmed.2018.08.012DOI Listing
November 2018

CL-L1 and CL-K1 Exhibit Widespread Tissue Distribution With High and Co-Localized Expression in Secretory Epithelia and Mucosa.

Front Immunol 2018 31;9:1757. Epub 2018 Jul 31.

Institute of Cancer and Inflammation Research, University of Southern Denmark, Odense, Denmark.

Collectin liver 1 (CL-L1, alias collectin 10) and collectin kidney 1 (CL-K1, alias collectin 11) are oligomeric pattern recognition molecules associated with the complement system, and mutations in either of their genes may lead to deficiency and developmental defects. The two collectins are reportedly localized and synthesized in the liver, kidneys, and adrenals, and can be found in the circulation as heteromeric complexes (CL-LK), which upon binding to microbial high mannose-like glycoconjugates activates the complement system the lectin activation pathway. The tissue distribution of homo- vs. heteromeric CL-L1 and -K1 complexes, the mechanism of heteromeric complex formation and in which tissues this occurs, is hitherto incompletely described. We have by immunohistochemistry using monoclonal antibodies addressed the precise cellular localization of the two collectins in the main human tissues. We find that the two collectins have widespread and almost identical tissue distribution with a high expression in epithelial cells in endo-/exocrine secretory tissues and mucosa. There is also accordance between localization of mRNA transcripts and detection of proteins, showing that local synthesis likely is responsible for peripheral localization and eventual formation of the CL-LK complexes. The functional implications of the high expression in endo-/exocrine secretory tissue and mucosa is unknown but might be associated with the activity of MASP-3, which has a similar pattern of expression and is known to potentiate the activity of the alternative complement activation pathway.
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http://dx.doi.org/10.3389/fimmu.2018.01757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079254PMC
September 2019

Mechanistic modelling of interventions against spread of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) within a Danish farrow-to-finish pig herd.

PLoS One 2018 12;13(7):e0200563. Epub 2018 Jul 12.

Division for Diagnostics and Scientific Advice, National Veterinary Institute, Technical University of Denmark, Lyngby, Denmark.

Knowledge on successful interventions against livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) within pig herds is sparse. In situations like this, a mechanistic simulation model can be a valuable tool for assessing the effect of potential intervention strategies, and prioritising which should be tested in the field. We have simulated on-farm interventions in a farrow-to-finish pig herd, with a previously published LA-MRSA spread model, within four different areas: 1) Reduced antimicrobial consumption, 2) Reduced number of pigs within each section, 3) Reduced mixing of pigs, and 4) Improved internal biosecurity. To model a decrease in the selective pressure, the transmission rates were reduced after LA-MRSA had become fully established within a herd, which resulted in a marked decrease in the prevalence within all stable units. However, LA-MRSA rarely disappeared completely from the herd; this was only observed in scenarios where the transmission rates were reduced to ≤ 30% of the original level. While changes in antimicrobial consumption patterns might be a very important step towards reducing the spread of LA-MRSA, the simulation results indicate that it may need to be paired with other preventive or intervention measures. Reducing the number of pigs within each section, reducing mixing of pigs, or improving internal biosecurity after LA-MRSA had become established within the herd only resulted in marginal changes in the median prevalence within the herd. However, these factors might be important in relation to being able to achieve or maintain a low level of antimicrobial consumption, and thus still indirectly influence the LA-MRSA prevalence within the herd. The results of a sensitivity analysis indicated the assumptions regarding the existence of pigs persistently shedding MRSA have a noticeable influence on the model results. The assumptions regarding transmission from sow to offspring at the day of birth also had a considerable influence on the MRSA prevalence within the farrowing unit but did not cause any marked changes in the simulated effect of interventions. Effects might differ between different farm types contaminated in different levels and this simulation study highlights a strong need for more knowledge from on-farm trials.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200563PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042764PMC
January 2019

A Multimodal Skin Cancer Prevention Program for Heart Transplant Patients.

Prog Transplant 2018 09 25;28(3):263-266. Epub 2018 Jun 25.

1 Advanced Heart Failure Clinic, University of Rochester Medical Center, Rochester, NY, USA.

Background: Immunosuppressant medications are essential for long-term survival following transplantation but increase the risk of developing skin cancer. Prevention and early detection of skin cancer requires screening and sun protection behaviors that can be achieved with patient education.

Problem Statement: Our method for educating post heart transplant patients regarding skin cancer was inconsistent and was not effective. The aim of this project was to develop and integrate a multimodal skin cancer education program to increase knowledge and protective behaviors for heart transplant recipients.

Methods: Twenty-five post heart transplant patients who were scheduled to be seen for routine posttransplant care at a single-center transplant center between October 26, 2016, and November 15, 2016, took part in a multimodal skin cancer education program.

Results: There was a significant increase in knowledge between pretest and posttest 1 ( P <.01) and pretest and posttest 2 ( P <.01). A significant increase in sun protective behavior was noted. The project noted that knowledge and behavior was retained, knowledge score posttest 1 to posttest 2 ( P = .085), all had seen a dermatologist or had an appointment scheduled, and self skin exam retention was noted between posttest 1 and posttest 2 ( P = .25). Process Addressed: The feasibility of and findings from this intervention have led the clinic team to implement this protocol as part of the standard care for all patients.

Conclusions: These data suggests that a multimodal intensive skin cancer education program may be effective at increasing knowledge and protective behavior with heart transplant recipients.
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http://dx.doi.org/10.1177/1526924818781561DOI Listing
September 2018

A mechanistic model for spread of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) within a pig herd.

PLoS One 2017 28;12(11):e0188429. Epub 2017 Nov 28.

National Veterinary Institute, Technical University of Denmark, Lyngby, Denmark.

Before an efficient control strategy for livestock-associated methicillin resistant Staphylococcus aureus (LA-MRSA) in pigs can be decided upon, it is necessary to obtain a better understanding of how LA-MRSA spreads and persists within a pig herd, once it is introduced. We here present a mechanistic stochastic discrete-event simulation model for spread of LA-MRSA within a farrow-to-finish sow herd to aid in this. The model was individual-based and included three different disease compartments: susceptible, intermittent or persistent shedder of MRSA. The model was used for studying transmission dynamics and within-farm prevalence after different introductions of LA-MRSA into a farm. The spread of LA-MRSA throughout the farm mainly followed the movement of pigs. After spread of LA-MRSA had reached equilibrium, the prevalence of LA-MRSA shedders was predicted to be highest in the farrowing unit, independent of how LA-MRSA was introduced. LA-MRSA took longer to spread to the whole herd if introduced in the finisher stable, rather than by gilts in the mating stable. The more LA-MRSA positive animals introduced, the shorter time before the prevalence in the herd stabilised. Introduction of a low number of intermittently shedding pigs was predicted to frequently result in LA-MRSA fading out. The model is a potential decision support tool for assessments of short and long term consequences of proposed intervention strategies or surveillance options for LA-MRSA within pig herds.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0188429PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705068PMC
December 2017

Macrophage migration inhibitory factor (MIF) modulates trophic signaling through interaction with serine protease HTRA1.

Cell Mol Life Sci 2017 12 19;74(24):4561-4572. Epub 2017 Jul 19.

Department of Molecular Medicine-Neurobiology Research, University of Southern Denmark, J.B. Winslows Vej 21.1, 5000, Odense, Denmark.

Macrophage migration inhibitory factor (MIF), a small conserved protein, is abundant in the immune- and central nervous system (CNS). MIF has several receptors and binding partners that can modulate its action on a cellular level. It is upregulated in neurodegenerative diseases and cancer although its function is far from clear. Here, we report the finding of a new binding partner to MIF, the serine protease HTRA1. This enzyme cleaves several growth factors, extracellular matrix molecules and is implicated in some of the same diseases as MIF. We show that the function of the binding between MIF and HTRA1 is to inhibit the proteolytic activity of HTRA1, modulating the availability of molecules that can change cell growth and differentiation. MIF is therefore the first endogenous inhibitor ever found for HTRA1. It was found that both molecules were present in astrocytes and that the functional binding has the ability to modulate astrocytic activities important in development and disease of the CNS.
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http://dx.doi.org/10.1007/s00018-017-2592-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663815PMC
December 2017

[Denosumab may be a supplement to the surgical treatment of giant cell tumours of bone].

Ugeskr Laeger 2016 Sep;178(36)

Giant cell tumour of bone (GCTB) is an aggressive bone tumour causing bone destruction. GCTB requires surgical treatment, and severe cases have a high risk of functional morbidity. GCTB consists of receptor activator of nuclear factor kappa-B (RANK)-positive osteoclast-like giant cells. The formation and activity of these cells are mediated by the interaction with RANK ligand (RANKL) released from neoplastic stromal cells. Denosumab is a human monoclonal antibody which inhibits RANKL and impairs the growth of the GCTB. Several studies have described the ability of denosumab to downgrade the extent of surgical treatment and improve the functional outcome.
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September 2016

Influenza A virus-mediated priming enhances cytokine secretion by human dendritic cells infected with Streptococcus pneumoniae.

Cell Microbiol 2013 Aug 14;15(8):1385-400. Epub 2013 Mar 14.

Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.

Secondary infections with Streptococcus pneumoniae (SP) are frequently observed following influenza A virus (IAV) infection and have a substantial impact on global health. Despite this, the basis for the disease progression is incompletely understood. To investigate the effect of co-infection on human monocyte-derived dendritic cells (MDDCs) we analysed the expression of clinically important pro-inflammatory and immune-modulatory cytokines. IAV infection or treatment with supernatants from IAV-infected cell cultures resulted in priming of the DCs which subsequently influenced the production of IL-12p70, as well as IL-6, following SP infection. Co-infection of the same cell was not required but this effect was dependent on the time, dose and duration of the infections, as well as pathogen viability, bacterial uptake and endosome acidification. Bacterially infected cells were characterized as the main producers of IL-12p70. Finally, we showed that type I interferons were primarily responsible for the priming of IL-12p70 that was observed by infection with IAV. These results provide a probable mechanism for the elevated levels of particular cytokines observed in IAV and SP co-infected cell cultures with implications for the pathogenic outcome observed during in vivo infection.
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http://dx.doi.org/10.1111/cmi.12122DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798092PMC
August 2013

Dysregulation of CD4+CD25+CD127lowFOXP3+ regulatory T cells in HIV-infected pregnant women.

Blood 2011 Feb 16;117(6):1861-8. Epub 2010 Dec 16.

Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.

Pregnancy represents a major challenge to immunologic tolerance. How the fetal "semiallograft" evades maternal immune attack is unknown. Pregnancy success may involve alteration of both central (thymic) and peripheral tolerance mechanisms. HIV infection is characterized by CD4(+) T-cell depletion, chronic immune activation, and altered lymphocyte subsets. We studied immunologic consequences of pregnancy in 20 HIV-infected women receiving highly active antiretroviral therapy (HAART), and for comparison in 16 HIV-negative women. Lymphocyte subsets, thymic output, and cytokine profiles were measured prospectively during pregnancy and postpartum. A significant expansion of CD4(+)CD25(+)CD127(low)FoxP3(+) regulatory T cells indicating alteration of peripheral tolerance was seen during second trimester, but only in HIV-negative women. HIV-infected women had lower CD4 counts, lower thymic output and Th-2 cytokines, and more immune activation at all time points compared with controls. Immune activation was decreased in HIV-infected patients during pregnancy. In contrast, CD4 counts were increased in both groups. In conclusion, the study does not indicate that pregnancy adversely affects the immunologic course of HIV infection. However, despite HAART during pregnancy, HIV-infected women display different immunologic profiles from HIV-negative women, which may have importance for the induction of fetal-maternal tolerance and in part explain the increased risk of abortion in HIV-infected women.
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http://dx.doi.org/10.1182/blood-2010-07-298992DOI Listing
February 2011

Improved thymic index, density and output in HIV-infected patients following low-dose growth hormone therapy: a placebo controlled study.

AIDS 2009 Oct;23(16):2123-31

Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.

Objectives: To investigate the effect of low-dose, long-term recombinant human growth hormone (rhGH) therapy on immune reconstitution in human immunodeficiency virus (HIV)-infected patients with focus on thymic index, density and output.

Design: Randomized, placebo-controlled, double-blind, single-centre trial.

Methods: Forty-six HIV-infected Caucasian men on highly active antiretroviral therapy, 21-60 years of age, were included. Twenty-eight patients were randomized to 0.7 mg/day rhGH and 18 patients to placebo, administrated as daily subcutaneous injections between 1300 and 1500 h for 40 weeks. Endpoints were changes from baseline in thymic size and thymic output measured as T-cell receptor rearrangement excision circles (TREC) frequency and total TREC content, and total and naive CD4 cells.

Results: Thymic density and thymic index increased in the GH group, compared with the placebo group (28 versus 4 Hounsfield units, P = 0.006 and 1 versus 0, P = 0.004). TREC frequency and total TREC content increased in the GH group, compared with the placebo group (37 versus -8%, P = 0.049 and 51 versus -14%, P = 0.026). Total CD4 cells and naive CD4+ cells increased insignificantly more in the GH than the placebo group [11.4%, 95% confidence interval (CI) -6.0 to 28.9; P = 0.19 and 18%, interquartile range (IQR) -4, 40 versus 13%, IQR -12, 39; P = 0.79]. Therapy was well tolerated.

Conclusions: Daily treatment with a low dose rhGH of 0.7 mg for 40 weeks stimulated thymopoiesis expressed by thymic index, density and area, TREC frequency and total TREC content in CD4 cells in HIV-infected patients on highly active antiretroviral therapy.
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http://dx.doi.org/10.1097/QAD.0b013e3283303307DOI Listing
October 2009

[Alternative treatment of migraine].

Authors:
Anna Sørensen

Ugeskr Laeger 2005 Aug;167(32):2917; author reply 2917

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August 2005

Induction of HIV-1-specific immunity after vaccination with apoptotic HIV-1/murine leukemia virus-infected cells.

J Immunol 2002 Nov;169(10):5771-9

Department of Medicine, Center for Infectious Medicine, Huddinge University Hospital, F82 Karolinska Institutet, S-141 86 Stockholm, Sweden.

Ag-presenting dendritic cells present viral Ags to T cells after uptake of apoptotic bodies derived from virus-infected cells in vitro. However, it is unclear whether apoptotic virus-infected cells are capable of generating immunity in vivo. In this study, we show that inoculation of mice with apoptotic HIV-1/murine leukemia virus (MuLV)-infected cells induces HIV-1-specific immunity. Immunization with apoptotic HIV-1/MuLV-infected syngeneic splenocytes resulted in strong Nef-specific CD8(+) T cell proliferation and p24-induced CD4(+) and CD8(+) T cell proliferation as well as IFN-gamma production. In addition, systemic IgG and IgA as well as mucosa-associated IgA responses were generated. Moreover, mice vaccinated with apoptotic HIV-1/MuLV cells were protected against challenge with live HIV-1/MuLV-infected cells, whereas mice vaccinated with apoptotic noninfected or MuLV-infected splenocytes remained susceptible to HIV-1/MuLV. These data show that i.p. immunization with apoptotic HIV-1-infected cells induces high levels of HIV-1-specific systemic immunity, primes for mucosal immunity, and induces protection against challenge with live HIV-1-infected cells in mice. These findings may have implications for the development of therapeutic and prophylactic HIV-1 vaccines.
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http://dx.doi.org/10.4049/jimmunol.169.10.5771DOI Listing
November 2002
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