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Interstitial lung disease (ILD) represents a significant cause of morbidity and mortality in systemic sclerosis (SSc). The purpose of this study was to examine recirculating lymphocytes from SSc patients for potential biomarkers of interstitial lung disease (ILD). Peripheral blood mononuclear cells (PBMCs) were isolated from patients with SSc and healthy controls enrolled in the Vanderbilt University Myositis and Scleroderma Treatment Initiative Center cohort between 9/2017–6/2019. Clinical phenotyping was performed by chart abstraction. Immunophenotyping was performed using both mass cytometry and fluorescence cytometry combined with t-distributed stochastic neighbor embedding analysis and traditional biaxial gating. This study included 34 patients with SSc-ILD, 14 patients without SSc-ILD, and 25 healthy controls. CD21lo/neg cells are significantly increased in SSc-ILD but not in SSc without ILD (15.4 ± 13.3% vs. 5.8 ± 0.9%, p = 0.002) or healthy controls (5.0 ± 0.5%, p < 0.0001). While CD21lo/neg B cells can be identified from a single biaxial gate, tSNE analysis reveals that the biaxial gate is comprised of multiple distinct subsets, all of which are increased in SSc-ILD. CD21lo/neg cells in both healthy controls and SSc-ILD are predominantly tBET positive and do not have intracellular CD21. Immunohistochemistry staining demonstrated that CD21lo/neg B cells diffusely infiltrate the lung parenchyma of an SSc-ILD patient. Additional work is needed to validate this biomarker in larger cohorts and longitudinal studies and to understand the role of these cells in SSc-ILD.
相似文献HIV-related stigma is a traumatizing experience operating across socioecological levels. Few interventions have combined multiple methods of stigma reduction into a comprehensive approach. This study adapted bystander training to the context of HIV-related stigma and pilot tested the model.
Subjects and methodsThe study drew upon the team’s prior research to create an adapted bystander intervention. Thirty-nine participants met in three separate workshop sessions, which consisted of didactic training, group discussions, and contact between people living with HIV (PLHIV) and their friends/family members, and healthcare workers. Participants completed pre-/post-intervention questionnaires that included demographic characteristics and standardized measures of stigma and empowerment. A person living openly with HIV served as the moderator. The study’s principal investigator led a discussion to evaluate the workshop model.
ResultsThe workshops were associated with decreased feelings of powerlessness but did not show any immediate effects on feelings of stigmatization. Subjects unanimously recommended requiring the training for all healthcare providers.
ConclusionThe study showed the feasibility of adapting a bystander approach to HIV-related stigma. Interactive participation across different stakeholder groups allows for addressing various types of stigma and incorporating multiple evidence-based approaches to stigma reduction. Future research will incorporate further adaptations and test the approach using a large-scale randomized controlled trial.
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