Immunotherapeutic And Immunoprophylactic Strategies For Infectious Diseases

In Immunotherapy for Infectious Disease, Jeffrey M. Jacobson, MD, and a panel of leading researchers review the state-of-the-art for treating various infections-particularly HIV-by manipulating the immune system's response rather than by chemical drugs. The contributors synthesize the principles of immune defense on the molecular level (monoclonal antibodies, vaccines, methods of antigen presentation, and cytokines and cytokine antagonists), as well as on the cellular and clinical levels levels as a protection against infection. The review of the current state of anti-HIV immunotherapy covers HIV-specific passive and active immunization strategies, gene therapy, and host cell-targeted approaches for treating HIV infection and restoring immune function.

In this issue of Infectious Disease Clinics of North America, guest editors Drs. Emily Sydnor Spivak and Sage Greenlee bring their considerable expertise to the topic of Antimicrobial Stewardship: Where We Have Come and Where We Are Going. Throughout the last decade, the field of antimicrobial stewardship has undergone exponential growth due to heightened awareness of antimicrobial use and emerging multidrug-resistant organisms. Additionally, the COVID-19 pandemic highlighted systemic and persistent health disparities in the United States. In this issue, top experts provide a recap of the progress made over the last decade in antimicrobial stewardship and provide direction for next steps in this ever-growing field. Contains 12 practice-oriented topics including antimicrobial stewardship and pandemic preparedness: lessons learned from COVID-19; health equity considerations; antimicrobial stewardship at transitions of care; antimicrobial stewardship in immunocompromised populations; health system and tele-antimicrobial stewardship: the role of building networks; and more. Provides in-depth clinical reviews on antimicrobial stewardship, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

The three years since our last conference in San Francisco have again seen a dramatic expansion of the number of antivirals either licensed or in the late stages of clinical trials. d4T is now licensed for HIV infection, famciclovir and the oral pro-drug of acyclovir, valacyclovir, are now licensed for VZV infections in some countries. Moreover. oral ganciclovir, cidofovir, and sorivudine are not far behind. Clinical trials with the second-site reverse transcriptase inhibitors and the protease inhibitors for HlV infection are proceeding rapidly and on a broad scale, and the preliminary results would suggest that several of these classes of drugs will be licensed as well. Despite this optimism, however, there is increasing evidence that antiviral-resistant strains of pathogenic viruses will be a significant problem, perhaps especially with therapy of HIV infection, and there remains a desperate need for improved drugs (with either improved efficacy or decreased toxicity, or both) for CMV and HIV infections. This book is the edited proceedings of the Fourth Triennial Conference on Antiviral Chemotherapy, held in San Francisco, in November 1994. The conference was sponsored by the University of California, San Francisco, and co-sponsored by the International Society for Antiviral Research (ISAR), the Macfarlane Burnet Centre for Medical Research in Melbourne, Australia, and the Australian National Centre for HIV Virology Research. The conference had been organized to present an overview of the field of antiviral chemotherapy.

This book describes a practical approach to the diagnosis, management, and prevention of infectious complications in solid-organ transplant (SOT) candidates and recipients, based on both up-to-date clinical evidence and state of the art expert opinion from world-renowned experts in the field. The book is divided into three parts, the first of which explains risk assessment and the general approach to infectious diseases in the pre-, peri-, and early and late post-transplant periods. The remaining two sections address the prevention and treatment of infection with particular pathogens and the management of specific syndromes, such as pneumonia, CNS infections, UTIs, and skin infections. Infections in SOT recipients – often due to multidrug-resistant organisms – represent a major challenge. Preventive strategies need to be adapted according to the type of allograft and period after transplantation. Moreover, toxicity and drug interaction with immunosuppressive drugs must be taken into consideration when treating infectious complications. In explaining in depth how best to ensure allograft and patient survival, this book will be of value to infectious disease specialists and transplant physicians at all levels of experience.

This comprehensive account of the human herpesviruses provides an encyclopedic overview of their basic virology and clinical manifestations. This group of viruses includes human simplex type 1 and 2, Epstein–Barr virus, Kaposi's Sarcoma-associated herpesvirus, cytomegalovirus, HHV6A, 6B and 7, and varicella-zoster virus. The viral diseases and cancers they cause are significant and often recurrent. Their prevalence in the developed world accounts for a major burden of disease, and as a result there is a great deal of research into the pathophysiology of infection and immunobiology. Another important area covered within this volume concerns antiviral therapy and the development of vaccines. All these aspects are covered in depth, both scientifically and in terms of clinical guidelines for patient care. The text is illustrated generously throughout and is fully referenced to the latest research and developments.

Over two decades an abundance of knowledge has been accumulated focus ing on the understanding of the molecular and cellular pathomechanisms of stressful conditions like systemic inflammation and sepsis. We have learned that there is a clear correlation between the magnitude of the inciting traumatic event and the degree of inflammatory dysbalance. The immunoinflammatory disintegration comprises a simultaneous col lapse of the otherwise very smoothly balanced pro- and antiinflammatory vectors of cytokine regulation. Most recently, we understood that it is predominantly the dysregulation of antiinflammatory mediators that plays a pivotal role for the phenomenon of trauma-induced depression or paralysis of cell-mediated immune responses. The substantial intellectual and logistic investments of numerous investi gators towards understanding the biology of sepsis inevitably lead us towards a rewarding status in terms of reaching spheres of clinical relevance. From the evolutionary collection of a multitude of ex-vivo and in-vivo immuno mechanistic parameters, some were found to represent most significant bio logical markers to support the clinician to characterize better the severity of inflammatory illness and to predict outcome. Chapter one of this book, authored by G. Grass and E.A.M. Neugebauer, analyses elegantly our current knowledge on the assessment of the immuno logical status in terms of risk and prognosis of sepsis.

For many years, experiments using chimpanzees have been instrumental in advancing scientific knowledge and have led to new medicines to prevent life-threatening and debilitating diseases. However, recent advances in alternate research tools have rendered chimpanzees largely unnecessary as research subjects. The Institute of Medicine, in collaboration with the National Research Council, conducted an in-depth analysis of the scientific necessity for chimpanzees in NIH-funded biomedical and behavioral research. The committee concludes that while the chimpanzee has been a valuable animal model in the past, most current biomedical research use of chimpanzees is not necessary, though noted that it is impossible to predict whether research on emerging or new diseases may necessitate chimpanzees in the future.