MD434Z - Method of predicting the course of endogenous uveitis - Google Patents
Method of predicting the course of endogenous uveitis Download PDFInfo
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- MD434Z MD434Z MDS20100208A MDS20100208A MD434Z MD 434 Z MD434 Z MD 434Z MD S20100208 A MDS20100208 A MD S20100208A MD S20100208 A MDS20100208 A MD S20100208A MD 434 Z MD434 Z MD 434Z
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- uveitis
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- 206010046851 Uveitis Diseases 0.000 title claims abstract description 22
- 238000000034 method Methods 0.000 title claims abstract description 12
- 210000001744 T-lymphocyte Anatomy 0.000 claims abstract description 8
- 230000004913 activation Effects 0.000 claims abstract description 8
- 238000005119 centrifugation Methods 0.000 claims abstract description 4
- 230000002349 favourable effect Effects 0.000 claims abstract description 4
- 210000002966 serum Anatomy 0.000 claims abstract description 4
- 210000004369 blood Anatomy 0.000 claims description 3
- 239000008280 blood Substances 0.000 claims description 3
- 239000003814 drug Substances 0.000 abstract description 2
- 238000010241 blood sampling Methods 0.000 abstract 1
- 239000008279 sol Substances 0.000 description 7
- UREBDLICKHMUKA-CXSFZGCWSA-N dexamethasone Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)CO)(O)[C@@]1(C)C[C@@H]2O UREBDLICKHMUKA-CXSFZGCWSA-N 0.000 description 5
- 229960003957 dexamethasone Drugs 0.000 description 5
- 102000004388 Interleukin-4 Human genes 0.000 description 4
- 108090000978 Interleukin-4 Proteins 0.000 description 4
- 229940028885 interleukin-4 Drugs 0.000 description 4
- 206010061218 Inflammation Diseases 0.000 description 3
- 230000001684 chronic effect Effects 0.000 description 3
- 230000004054 inflammatory process Effects 0.000 description 3
- MZOFCQQQCNRIBI-VMXHOPILSA-N (3s)-4-[[(2s)-1-[[(2s)-1-[[(1s)-1-carboxy-2-hydroxyethyl]amino]-4-methyl-1-oxopentan-2-yl]amino]-5-(diaminomethylideneamino)-1-oxopentan-2-yl]amino]-3-[[2-[[(2s)-2,6-diaminohexanoyl]amino]acetyl]amino]-4-oxobutanoic acid Chemical compound OC[C@@H](C(O)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CCCN=C(N)N)NC(=O)[C@H](CC(O)=O)NC(=O)CNC(=O)[C@@H](N)CCCCN MZOFCQQQCNRIBI-VMXHOPILSA-N 0.000 description 2
- 108060008682 Tumor Necrosis Factor Proteins 0.000 description 2
- 102000000852 Tumor Necrosis Factor-alpha Human genes 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 2
- 230000001363 autoimmune Effects 0.000 description 2
- 201000010099 disease Diseases 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 238000002347 injection Methods 0.000 description 2
- 239000007924 injection Substances 0.000 description 2
- 238000011835 investigation Methods 0.000 description 2
- 238000004393 prognosis Methods 0.000 description 2
- 206010003267 Arthritis reactive Diseases 0.000 description 1
- 208000002691 Choroiditis Diseases 0.000 description 1
- 241000909851 Epiphora Species 0.000 description 1
- 206010015958 Eye pain Diseases 0.000 description 1
- 206010034960 Photophobia Diseases 0.000 description 1
- 208000003971 Posterior uveitis Diseases 0.000 description 1
- 241000700584 Simplexvirus Species 0.000 description 1
- 208000037855 acute anterior uveitis Diseases 0.000 description 1
- 230000003110 anti-inflammatory effect Effects 0.000 description 1
- 230000002146 bilateral effect Effects 0.000 description 1
- 206010005159 blepharospasm Diseases 0.000 description 1
- 230000000744 blepharospasm Effects 0.000 description 1
- 230000001413 cellular effect Effects 0.000 description 1
- 230000007012 clinical effect Effects 0.000 description 1
- 230000001143 conditioned effect Effects 0.000 description 1
- 238000001514 detection method Methods 0.000 description 1
- 230000005713 exacerbation Effects 0.000 description 1
- 230000001900 immune effect Effects 0.000 description 1
- 230000028993 immune response Effects 0.000 description 1
- 230000036039 immunity Effects 0.000 description 1
- 238000001802 infusion Methods 0.000 description 1
- 230000000977 initiatory effect Effects 0.000 description 1
- 238000001990 intravenous administration Methods 0.000 description 1
- 208000016747 lacrimal apparatus disease Diseases 0.000 description 1
- 210000000265 leukocyte Anatomy 0.000 description 1
- 208000026475 palpebral edema Diseases 0.000 description 1
- 208000002574 reactive arthritis Diseases 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000009885 systemic effect Effects 0.000 description 1
- 230000004382 visual function Effects 0.000 description 1
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- Investigating Or Analysing Biological Materials (AREA)
Abstract
Description
Invenţia se referă la medicină, în special la oftalmologie şi poate fi utilizată pentru prognozarea evoluţiei uveitei endogene. The invention relates to medicine, in particular to ophthalmology and can be used for predicting the evolution of endogenous uveitis.
Este cunoscută metoda de prognozare a evoluţiei uveitelor, care constă în aceea că în cultura leucocitelor se introduce cultura virusului Herpes Simplex (inactivată), apoi peste 24 de ore se determină TNF-α şi a interleukinei 4 (IL-4), în cazul în care conţinutul TNF-α depăşeşte valoarea de 200 picograme/mililitru, iar interleukina 4 (IL-4) nu se determină se prognozează o evoluţie nefavorabilă a uveitelor [1]. There is a known method for predicting the evolution of uveitis, which consists in introducing the Herpes Simplex virus culture (inactivated) into the leukocyte culture, then after 24 hours TNF-α and interleukin 4 (IL-4) are determined, if the TNF-α content exceeds the value of 200 picograms/milliliter, and interleukin 4 (IL-4) is not determined, an unfavorable evolution of uveitis is predicted [1].
Dezavantajul metodei date constă în aceea că aceasta relevă doar gradul reacţiei inflamatorii la nivelul focarului, condiţionat de factori umorali şi celulari ai imunităţii locale şi sistemice şi nu reflectă componentul autoimun, care joacă un rol important în uveite, totodată metoda dată este complicată în utilizare, necesită utilaj şi condiţii de realizare speciale. The disadvantage of this method is that it only reveals the degree of inflammatory reaction at the level of the focus, conditioned by humoral and cellular factors of local and systemic immunity and does not reflect the autoimmune component, which plays an important role in uveitis. At the same time, this method is complicated to use, requires special equipment and conditions.
Problema pe care o rezolvă invenţia propusă constă în prognozarea mai calitativă şi exactă a evoluţiei uveitelor, în special a celor cu component autoimun, precum şi prognozarea recidivelor acestora. The problem solved by the proposed invention consists in more qualitative and accurate prediction of the evolution of uveitis, especially those with an autoimmune component, as well as the prediction of their relapses.
Conform invenţiei, metoda de prognozare a evoluţiei uveitei endogene constă în aceea că la a 3…4-a zi de tratament se colectează sânge, din care se separă serul prin centrifugare, se determină numărul total de T limfocite (CD3+) şi numărul de T limfocite mature (CD5+), după care se calculează indicele de activare (IA), conform formulei, în % : According to the invention, the method for predicting the evolution of endogenous uveitis consists in that on the 3rd...4th day of treatment, blood is collected, from which the serum is separated by centrifugation, the total number of T lymphocytes (CD3+) and the number of mature T lymphocytes (CD5+) are determined, after which the activation index (IA) is calculated, according to the formula, in %:
şi în cazul în care se determină valori de până la 50% se prognozează o evoluţie favorabilă a uveitei endogene, iar în cazul în care se determină valori mai mari de 60% se prognozează o evoluţie nefavorabilă. and if values up to 50% are determined, a favorable evolution of endogenous uveitis is predicted, and if values greater than 60% are determined, an unfavorable evolution is predicted.
Determinarea indicelui de activare la a 3…4-a zi de tratament permite de a aprecia o evoluţie acută sau cronică a inflamaţiei oculare, precum şi de a prescrie un tratament adecvat. Determining the activation index on the 3rd...4th day of treatment allows us to assess the acute or chronic evolution of ocular inflammation, as well as to prescribe appropriate treatment.
Rezultatul invenţiei constă în prognozarea mai calitativă şi exactă a evoluţiei uveitelor şi prescrierea unui tratament etiopatogenic adecvat în scopul prevenirii complicaţiilor uveitelor. The result of the invention consists in a more qualitative and accurate prognosis of the evolution of uveitis and the prescription of an adequate etiopathogenic treatment in order to prevent uveitis complications.
Metoda revendicată are o exactitate şi eficacitate înaltă, este simplă în utilizare, totodată permite depistarea corelaţiei dintre indicele de activare a răspunsului imun şi efectul clinic precoce al tratamentului adecvat aplicat. The claimed method has high accuracy and effectiveness, is simple to use, and also allows the detection of the correlation between the immune response activation index and the early clinical effect of the appropriate treatment applied.
De asemenea metoda revendicată permite indicarea unui tratament etiopatogenic, cu micşorarea ratei recidivelor uveitelor şi duratei spitalizării pacienţilor. Pe lângă aceasta, metoda elaborată permite prognozarea recidivelor uveitelor, prin indicarea unui tratament antiinflamator intens sau evaluarea eficienţei tratamentului aplicat şi corecţia acestuia la necesitate. O prioritate incontestabilă a metodei propuse este faptul că investigaţia se efectuează o singură dată. The claimed method also allows for the indication of an etiopathogenic treatment, with a decrease in the rate of uveitis relapses and the duration of hospitalization of patients. In addition, the developed method allows for the prognosis of uveitis relapses, by indicating an intensive anti-inflammatory treatment or evaluating the effectiveness of the applied treatment and its correction if necessary. An indisputable priority of the proposed method is the fact that the investigation is performed only once.
Metoda se realizează în modul următor: la a 3…4-a zi de tratament se colectează sânge, din care se separă serul prin centrifugare, se determină numărul total de T limfocite (CD3+) şi numărul de T limfocite mature (CD5+), după care se calculează indicele de activare (IA), conform formulei, în % : The method is performed as follows: on the 3rd…4th day of treatment, blood is collected, from which the serum is separated by centrifugation, the total number of T lymphocytes (CD3+) and the number of mature T lymphocytes (CD5+) are determined, after which the activation index (IA) is calculated, according to the formula, in %:
şi în cazul în care se determină valori de până la 50% se prognozează o evoluţie favorabilă a uveitei endogene, iar în cazul în care se determină valori mai mari de 60% se prognozează o evoluţie nefavorabilă. and if values up to 50% are determined, a favorable evolution of endogenous uveitis is predicted, and if values greater than 60% are determined, an unfavorable evolution is predicted.
Exemplul 1 Example 1
Pacienta G., 34 ani, cu diagnosticul de uveită anterioară acută la ochiul stâng. Artrită reactivă, formă urogenitală. La internare AV = OS - 0,09, OD - 1,0. La a 3-a zi de la iniţierea tratamentului au fost evaluaţi parametrii imuni: CD5+/CD3+. Patient G., 34 years old, diagnosed with acute anterior uveitis in the left eye. Reactive arthritis, urogenital form. Upon admission, AV = OS - 0.09, OD - 1.0. On the 3rd day after the start of treatment, immune parameters were evaluated: CD5+/CD3+.
Prin evaluarea rezultatelor obţinute la a 3-a zi de tratament a fost stabilit un indice de activare egal cu 15,62%. Rezultatele investigaţiilor imunologice au fost confirmate şi de către datele clinice subiective şi obiective ale pacientei: micşorarea durerii oculare, fotofobiei, epiforei, blefarospasmului. La examenul obiectiv: diminuarea edemului palpebral, congestiei pericheratice. Pacienta a urmat un tratament de scurtă durată (5…7 zile). Local s-a administrat Sol. de Dexametazonă 0,1%, câte 2 picături de 3…4 ori pe zi, Sol. de Clodifen 0,1%, câte 2 picături de 3 ori pe zi, injecţii parabulbare cu Sol. de Dexametazonă 4 mg - 0,5 ml. Pentru perioada de observare de 4 ani uveita la pacientă nu s-a repetat. Funcţiile vizuale au fost restabilite total AV= OS - 1,0. By evaluating the results obtained on the 3rd day of treatment, an activation index equal to 15.62% was established. The results of the immunological investigations were also confirmed by the patient's subjective and objective clinical data: reduction of ocular pain, photophobia, epiphora, blepharospasm. On objective examination: reduction of palpebral edema, perikerat congestion. The patient underwent a short-term treatment (5…7 days). Locally, 0.1% Dexamethasone Sol. was administered, 2 drops 3…4 times a day, 0.1% Clodifen Sol., 2 drops 3 times a day, parabulbar injections with 4 mg - 0.5 ml Dexamethasone Sol. During the 4-year observation period, the patient's uveitis did not recur. Visual functions were completely restored AV = OS - 1.0.
Exemplul 2 Example 2
Pacientul B., 21 ani, cu diagnosticul de uveită posterioară bilaterală, evoluţie cronică, fază acută la ambii ochi. La internare AV=OD - 0,04; OS - 0,06. La a 3-a zi de la iniţierea tratamentului a fost determinat indicele de activare = 70,55%. Uveita a avut o tendinţă de recuperare funcţională lentă şi dificilă. Reabilitarea funcţională a fost parţială, iar maladia ulterior a decurs cu recidive repetate de 3 ori pentru perioada de opservare de 4 ani. Localizarea anatomică posterioară a uveitei, evoluţia cronică a bolii, cât şi afectarea ambilor ochi a dictat o evoluţie gravă a inflamaţiei oculare. Pacientul a urmat un tratament local cu Sol. de Dexametazonă 0,1%, câte 2 picături de 3…4 ori pe zi, Sol. de Clodifen 0,1%, câte 2 picături de 3 ori pe zi, injecţii parabulbare cu Sol. de Dexametazonă 4 mg - 0,5 ml şi perfuzii intavenoase cu Sol. de Dexametazonă 0,5 mg/kg/zi, cu scăderea gradată a dozei. Durata tratamentului în condiţii de staţionar a fost de 13 zile. La externare AV= OD - 0,5; OS-0,63. Perioada de acalmie a fost de 8,5 luni, după care a survenit acutizarea uveitei. Patient B., 21 years old, diagnosed with bilateral posterior uveitis, chronic evolution, acute phase in both eyes. Upon admission AV=OD - 0.04; OS - 0.06. On the 3rd day after the initiation of treatment, the activation index was determined = 70.55%. Uveitis had a tendency for slow and difficult functional recovery. Functional rehabilitation was partial, and the disease subsequently progressed with repeated relapses 3 times for the observation period of 4 years. The posterior anatomical location of the uveitis, the chronic evolution of the disease, as well as the involvement of both eyes dictated a serious evolution of the ocular inflammation. The patient underwent local treatment with Sol. of Dexamethasone 0.1%, 2 drops 3…4 times a day, Sol. Clodifen 0.1%, 2 drops 3 times a day, parabulbar injections with Dexamethasone Sol. 4 mg - 0.5 ml and intravenous infusions with Dexamethasone Sol. 0.5 mg/kg/day, with a gradual decrease in the dose. The duration of treatment in inpatient conditions was 13 days. At discharge AV= OD - 0.5; OS-0.63. The period of calm was 8.5 months, after which the uveitis exacerbation occurred.
1. RU 2298188 C1 2007.04.27 1. RU 2298188 C1 2007.04.27
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20100208A MD434Z (en) | 2010-12-01 | 2010-12-01 | Method of predicting the course of endogenous uveitis |
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| MDS20100208A MD434Z (en) | 2010-12-01 | 2010-12-01 | Method of predicting the course of endogenous uveitis |
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| MD434Y MD434Y (en) | 2011-11-30 |
| MD434Z5 MD434Z5 (en) | 2012-06-30 |
| MD434Z true MD434Z (en) | 2012-06-30 |
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Family Cites Families (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| SU764659A1 (en) * | 1977-09-29 | 1980-09-23 | 2-Ой Московский Ордена Ленина Государственный Медицинский Институт Им. Н.И.Пирогова | Method of detecting allergic inflammation at uveitis |
| SU1727074A1 (en) * | 1989-11-14 | 1992-04-15 | Московский научно-исследовательский институт глазных болезней им.Гельмгольца | Method for prognosis of uveitis relapses |
| SU1734022A1 (en) * | 1990-01-15 | 1992-05-15 | Астраханский государственный медицинский институт им.А.В.Луначарского | Method for assessing effectiveness of treatment for uveitis |
| SU1783444A1 (en) * | 1990-08-16 | 1992-12-23 | Mo Nii Tuberkuleza | Method for diagnosis of tuberculous uveitis |
| RU2157541C1 (en) * | 1999-06-01 | 2000-10-10 | Дроздова Елена Александровна | Method for predicting uveitis development course in the cases of systemic or syndromic diseases |
| MD1804G2 (en) * | 1999-07-05 | 2002-06-30 | Константин ЖУКОВСКИЙ | Method of prognosticating the primary open-angle glaucoma surgical treatment results |
| MD3073G2 (en) * | 2005-07-06 | 2007-01-31 | Наталия ЛУПАШКО | Method of prognosticating the risk of appearance of the eyeball degenerative-inflammatory complications after laser discission of the secondary cataract |
| RU2298188C1 (en) * | 2005-09-19 | 2007-04-27 | Московский научно-исследовательский институт глазных болезней им. Гельмгольца | Method for predicting unfavorable clinical course of uveitis |
| MD3795G2 (en) * | 2007-08-30 | 2009-08-31 | ЧЕРОЙДА Петру | Method for determining the degree of severity of hypertensive retinopathy |
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| Publication number | Publication date |
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| MD434Z5 (en) | 2012-06-30 |
| MD434Y (en) | 2011-11-30 |
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