Objective: This clinical practice guideline addresses the diagnosis and treatment of primary adrenal insufficiency. Participants: The Task Force included a chair, selected by The Clinical Guidelines Subcommittee of the Endocrine Society, eight additional clinicians experienced with the disease, a methodologist, and a medical writer. The co-sponsoring associations (European Society of Endocrinology and the American Association for Clinical Chemistry) had participating members. The Task Force received no corporate funding or remuneration in connection with this review. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to determine the strength of recommendations and the quality of evidence. Consensus Process: The evidence used to formulate recommendations was derived from two commissioned systematic reviews as well as other published systematic reviews and studies identified by the Task Force. The guideline was ...

/pdf/diagnosis-and-treatment-of-primary-adrenal-insufficiency-an-4ilgjyu2yg.pdf

Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline.

Platelet-Derived Growth Factor

Inflammatory processes in chronic rejection remain a serious clinical problem in organ transplantation Activated cellular infiltrate produces high levels of both superoxide and nitric oxide These reactive oxygen species interact to form peroxynitrite, a potent oxidant that can modify proteins to form 3-nitrotyrosine We identified enhanced immunostaining for nitrotyrosine localized to tubular epithelium of chronically rejected human renal allografts Western blot analysis of rejected tissue demonstrated that tyrosine nitration was restricted to a few specific polypeptides Immunoprecipitation and amino acid sequencing techniques identified manganese superoxide dismutase, the major antioxidant enzyme in mitochondria, as one of the targets of tyrosine nitration Total manganese superoxide dismutase protein was increased in rejected kidney, particularly in the tubular epithelium; however, enzymatic activity was significantly decreased Exposure of recombinant human manganese superoxide dismutase to peroxynitrite resulted in a dose-dependent (IC50 = 10 microM) decrease in enzymatic activity and concomitant increase in tyrosine nitration Collectively, these observations suggest a role for peroxynitrite during development and progression of chronic rejection in human renal allografts In addition, inactivation of manganese superoxide dismutase by peroxynitrite may represent a general mechanism that progressively increases the production of peroxynitrite, leading to irreversible oxidative injury to mitochondria

Nitration and inactivation of manganese superoxide dismutase in chronic rejection of human renal allografts

Uncommitted (naive) murine CD4+ T helper cells (Thp) can be induced to differentiate towards T helper 1 (Th1), Th2, Th17 and regulatory (Treg) phenotypes according to the local cytokine milieu. This can be demonstrated most readily both in vitro and in vivo in murine CD4+ T cells. The presence of interleukin (IL)-12 [signalling through signal transduction and activator of transcription (STAT)-4] skews towards Th1, IL-4 (signalling through STAT-6) towards Th2, transforming growth factor (TGF)-beta towards Treg and IL-6 and TGF-beta towards Th17. The committed cells are characterized by expression of specific transcription factors, T-bet for Th1, GATA-3 for Th2, forkhead box P3 (FoxP3) for Tregs and RORgammat for Th17 cells. Recently, it has been demonstrated that the skewing of murine Thp towards Th17 and Treg is mutually exclusive. Although human Thp can also be skewed towards Th1 and Th2 phenotypes there is as yet no direct evidence for the existence of discrete Th17 cells in humans nor of mutually antagonistic development of Th17 cells and Tregs. There is considerable evidence, however, both in humans and in mice for the importance of interferon (IFN)-gamma and IL-17 in the development and progression of inflammatory and autoimmune diseases (AD). Unexpectedly, some models of autoimmunity thought traditionally to be solely Th1-dependent have been demonstrated subsequently to have a non-redundant requirement for Th17 cells, notably experimental allergic encephalomyelitis and collagen-induced arthritis. In contrast, Tregs have anti-inflammatory properties and can cause quiescence of autoimmune diseases and prolongation of transplant function. As a result, it can be proposed that skewing of responses towards Th17 or Th1 and away from Treg may be responsible for the development and/or progression of AD or acute transplant rejection in humans. Blocking critical cytokines in vivo, notably IL-6, may result in a shift from a Th17 towards a regulatory phenotype and induce quiescence of AD or prevent transplant rejection. In this paper we review Th17/IL-17 and Treg biology and expand on this hypothesis.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-2249.2007.03356.x

The role of T helper 17 (Th17) and regulatory T cells (Treg) in human organ transplantation and autoimmune disease

Objective: To formulate clinical practice guidelines for hormonal replacement in hypopituitarism in adults. Participants: The participants include an Endocrine Society-appointed Task Force of six experts, a methodologist, and a medical writer. The American Association for Clinical Chemistry, the Pituitary Society, and the European Society of Endocrinology co-sponsored this guideline. Evidence: The Task Force developed this evidence-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies. Consensus Process: One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the American Association for Clinical Chemistry, the Pituitary Society, and the European Society of ...

/pdf/hormonal-replacement-in-hypopituitarism-in-adults-an-218mx1w82n.pdf

Hormonal replacement in hypopituitarism in adults: An endocrine society clinical practice guideline

Context: Patients with treated adrenal insufficiency (AI) have increased morbidity and mortality rate. Our goal was to improve outcome by developing a once-daily (OD) oral hydrocortisone dual-relea ...

/pdf/improved-cortisol-exposure-time-profile-and-outcome-in-2f3a0z6vac.pdf

Improved cortisol exposure-time profile and outcome in patients with adrenal insufficiency: a prospective randomized trial of a novel hydrocortisone dual-release formulation.

Tissue distribution of macrophages, class II transplantation antigens, and receptors for platelet-derived growth factor in normal and rejected human kidneys.

Macrophages and T lymphocytes expressing HLA-D region-encoded gene products in rejected renal transplants.

Chronic Vascular Rejection

SUMMARY Adhesion of plasticized PVC moulded on PA6 monofilaments and of droplets formed from knotted PP-fibres on E-glass fibres have been studied as a function of time and temperature of heat treatment. For the adhesion studies, a self ajusting microdroplet debonding test rig has been developed. (Keywords: Adhesion, microbonding, thermoplastic)

J Wahlberg

Papers

Improved cortisol exposure-time profile and outcome in patients with adrenal insufficiency: a prospective randomized trial of a novel hydrocortisone dual-release formulation.

Tissue distribution of macrophages, class II transplantation antigens, and receptors for platelet-derived growth factor in normal and rejected human kidneys.

Macrophages and T lymphocytes expressing HLA-D region-encoded gene products in rejected renal transplants.

Chronic Vascular Rejection

Wetting and adhesion of some thermoplastic materials to fibres