Refine
Has Fulltext
- yes (4)
Is part of the Bibliography
- yes (4)
Document Type
- Journal article (3)
- Doctoral Thesis (1)
Language
- English (4)
Keywords
- Diagnose (1)
- Dünnschichttransistor (1)
- GRAID (1)
- Organischer Halbleiter (1)
- Pentacen (1)
- Perylenbisimid (1)
- S2k guidelines (1)
- allotype (1)
- autoantibodies (1)
- dermatology (1)
- functional genetics (1)
- half-life (1)
- immunology (1)
- organic semiconductor (1)
- organischer Feldeffekttransistor (1)
- pemphigoid (1)
- pemphigus (1)
- pemphigus foliaceus (1)
- pemphigus vulgaris (1)
- pentacene (1)
- perylene bisimide (1)
- thin film transistor (1)
Introduction:
Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin’s lymphoma in a real-life clinical setting.
Methods:
Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators.
Results:
A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0% with systemic lupus erythematosus, 15.7% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1% multiple sclerosis and 10.0% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3% of patients showed no response, 45.1% showed a partial response and 41.6% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician’s visual analogue scale; mean improvement from baseline of 12.1 mm)
This thesis deals with the synthesis of improved organic semiconductors, the detailed investigation of the molecular properties and the solid state arrangements revealed by single crystal X-ray diffraction and finally the development of structureperformance dependencies by measuring of the charge carrier mobilities of the derivatives in thin film transistors. The two main-goals of this thesis were achieved. Well soluble acene derivatives for spin-coated TFTs were obtained, showing charge carrier mobilities in the range of polymer p-type materials. Novel core-fluorinated perylene bisimide dyes were synthesized particularly and the use of electron deficient substituents lead to PBIs with outstanding air-stable mobilities in thin film transistors prepared by vacuum deposition techniques. The relationship between performance, air stability and solid state packing was elucidated in detail by single crystal X-ray diffraction analysis.
IgG3 is the IgG subclass with the strongest effector functions among all four IgG subclasses and the highest degree of allelic variability among all constant immunoglobulin genes. Due to its genetic position, IgG3 is often the first isotype an antibody switches to before IgG1 or IgG4. Compared with the other IgG subclasses, it has a reduced half-life which is probably connected to a decreased affinity to the neonatal Fc receptor (FcRn). However, a few allelic variants harbor an amino acid replacement of His435 to Arg that reverts the half-life of the resulting IgG3 to the same level as the other IgG subclasses. Because of its functional impact, we hypothesized that the p.Arg435His variation could be associated with susceptibility to autoantibody-mediated diseases like pemphigus vulgaris (PV) and bullous pemphigoid (BP). Using a set of samples from German, Turkish, Egyptian, and Iranian patients and controls, we were able to demonstrate a genetic association of the p.Arg435His variation with PV risk, but not with BP risk. Our results suggest a hitherto unknown role for the function of IgG3 in the pathogenesis of PV.