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Hematopoietic Stem Cell Transplantation for Multiple Sclerosis
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Athanasios Fassas, Richard K. Burt
During mobilization, there was no mortality. However, a limited number of cytopenic infections occurred, and, an incident of epilepsy, ascribed to G-CSF, occurred in one patient, and another worsened significantly while on G-CSF, with appearance of new lesions in the MRI scan. Early post-transplant toxicity included reactions to ATG, mild mucositis, cytopenic infections, one case of mild liver veno-occlusive disease, one case of mild thrombotic thrombocytopenic purpura, and one fatal case of pulmonary and cerebral aspergillosis. There were no delayed hematological recoveries or graft failures. In all, the rate of grade 3 plus 4 medical toxicity was 89% and the therapy-related mortality (TRM) was 3% (1/35). A degree of mild neurological deterioration developed in 13 patients (37%), owing to fever, infection, or possibly to G-CSF given post transplant for hematological recovery. Later toxicities included viral reactivations occurring in the first hundred days and leading to disease in two patients (one CMV pneumonitis, one zoster), and a case of autoimmune thyroiditis diagnosed eleven months post HSCT. CD4+ cytopenia was profound and prolonged for up to two years after HSCT. Median follow-up time at last assessment was 35 months (range, 3-67).
The toxic contaminants of Aspalathus linearis plant material as well as herb–drug interactions may constitute the health risk factors in daily rooibos tea consumers
Published in International Journal of Environmental Health Research, 2023
Since phenolic compounds are overall regarded as hepatoprotective, the question arises about the possible mechanism of detrimental influence of herbal teas. However, research on toxic plant constituents is conducted for over century still the safety of many herbal products remains unknown (Manteiga et al. 1997). Plants produce various metabolites for defense purposes against other plants, parasite, and herbivores. The prevalence of pyrrolizidine alkaloids (PAs) and their N-oxides (PANOs), secondary metabolites of plant families such as Fabaceae, impacts public health and demands a need for prevention of intoxication since they are known to be hepatotoxic to humans and animals (Van Wyk et al. 2017; He et al. 2019; EMA 2020). These naturally occurring substances in abundance may cause liver injury due to hepatosinusoidal obstruction syndrome and hepatic veno-occlusive disease with centrilobular hepatocellular necrosis, and in preclinical investigation were responsible for genotoxic, carcinogenic and teratogenic effects. The prolonged exposition may be associated with liver cirrhosis and hepatocellular carcinoma development.