Rare disease conceptH_Ko / stock.adobe.comAutoimmune encephalitis is a rare condition affecting 1 in 100,000 people per year in the UK according to the Encephalitis Society. Autoimmune encephalitis is a swelling in the brain caused by the immune system attacking the body in error. It can cause people to become confused, and drowsy, exhibit changes in behaviour, and have seizures. Some patients recover completely, but in others, it can cause death or severe disability.
improve, clinicians often give intravenous immunoglobulin . IVIG is expensive and can sometimes cause serious side effects. Some doctors also think that if IVIG is used from the start of treatment, patients may recover more quickly and have fewer side effects from the illness. Enceph-IG is an individually randomized controlled trial of 356 adults. All patients will receive steroids and then half will receive IVIG and the other half will receive a placebo. The study will be carried out at about 50 hospitals in the UK. Over the last year, we have opened the study in six sites and recruited nine participants, but things haven’t been easy.
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Monocyte, neutrophil, and whole blood transcriptome dynamics following ischemic stroke - BMC MedicineBackground After ischemic stroke (IS), peripheral leukocytes infiltrate the damaged region and modulate the response to injury. Peripheral blood cells display distinctive gene expression signatures post-IS and these transcriptional programs reflect changes in immune responses to IS. Dissecting the temporal dynamics of gene expression after IS improves our understanding of immune and clotting responses at the molecular and cellular level that are involved in acute brain injury and may assist with time-targeted, cell-specific therapy. Methods The transcriptomic profiles from peripheral monocytes, neutrophils, and whole blood from 38 ischemic stroke patients and 18 controls were analyzed with RNA-seq as a function of time and etiology after stroke. Differential expression analyses were performed at 0–24 h, 24–48 h, and |48 h following stroke. Results Unique patterns of temporal gene expression and pathways were distinguished for monocytes, neutrophils, and whole blood with enrichment of interleukin signaling pathways for different time points and stroke etiologies. Compared to control subjects, gene expression was generally upregulated in neutrophils and generally downregulated in monocytes over all times for cardioembolic, large vessel, and small vessel strokes. Self-organizing maps identified gene clusters with similar trajectories of gene expression over time for different stroke causes and sample types. Weighted Gene Co-expression Network Analyses identified modules of co-expressed genes that significantly varied with time after stroke and included hub genes of immunoglobulin genes in whole blood. Conclusions Altogether, the identified genes and pathways are critical for understanding how the immune and clotting systems change over time after stroke. This study identifies potential time- and cell-specific biomarkers and treatment targets.
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