When is an autoimmune disease not an autoimmune disease?

What are the enviromental triggers and genetic susceptibilities underlying the development of autoimmune diseases? These and other questions were addressed at a recent meeting in Finland¹.     

Dehnungseffekte an Froschmuskulatur mit hohem Anteil an „tonischen“ Fasern

Ohne Zusammenfassung     

Erotomania preceding an aneurysmal subarachnid hemorrhage: is there an association?

Clear symptoms of erotomania were observed in a woman with past history of high blood pressure who, later, presented a slight subarachnoid hemorrhage from a ruptured anterior cerebral communicating artery aneurysm. The possibility that erotomania, in this case, may be related to the patient’s organic brain damage is discussed.     

Human African trypanosomiasis in an urban area: an emerging problem?

The human African trypanosomiasis is essentially a rural disease. The notification of cases in urban area has always been incidental; either a diagnosis made in town revealed a disease contracted in rural environment or it meant the preservation of a complete epidemiological cycle in a remaining urban micro-focus. In Kinshasa, in Democratic Republic of Congo, about forty cases have been notified each year. All of them came from the nearby foci of Bandundu, Lower Congo and Kasa?. In 1996 the number of cases reached suddenly 254 and today the average annual number comes up to 500 in spite of all the efforts undertaken to fight the disease. A study of cases in 1998 and 1999 shows that patients are essentially distributed in suburbs and that the most affected by the disease are the 15-49 year old ones whose job is related with agricultural or fishing activities. Two phenomena seem to explain this sudden increase: the massive inflow of refugees in outskirts of town coming from provinces where trypanosomiasis is endemic and a major economic crisis throwing out urban population in suburbs living on a subsistence micro-agriculture. These concomitant factors have contributed to the setting up of a trypanosomiasis belt around the capital. Today a strategy has to be reconsidered in order to fight against the disease in the capital itself and to make the medical staff aware of the diagnosis of a disease still unknown in their sanitary district.     

Multiple sclerosis: an altered immune response or an altered stress response?

The pathogenesis of multiple sclerosis (MS), the major neurological disease of young adults in the Western world, is still poorly understood, and no effective therapy to block MS is available as yet. The clinical symptoms of MS result from inflammatory damage to the insulating myelin sheath of axons in the CNS and — at later stages — to axons themselves. A local autoimmune process involving activation of helper T cells against CNS protein components is likely to be crucial in this development. Especially at the first stages of MS, therapies aimed at the selective downregulation of MS-specific autoimmune responses may contribute to controlling the disease. Key to the success of such approaches is the identification of CNS proteins that are the target of local T cell responses. We recently identified the small heat-shock protein B-crystallin as the single immunodominant myelin antigen in MS-affected myelin. This review discusses the functional and therapeutic implications of this finding along with other data on MS, and hypothesizes that an inappropriate stress response within the CNS itself is crucial as an initiating event in disease development.Abbreviations APC Antigen-presenting cells - BBB Blood-brain barrier - EAE Experimental allergic encephalomyelitis - HPLC High-performance liquid chromatography - HSP Heat-shock protein - IFN Interferon - IL Interleukin - MBP Myelin basic protein - MS Multiple sclerosis - TNF Tumor necrosis factor     

What makes an allergen?

Allergic diseases are an immune disorder reacting to certain type of allergen(s). Remarkably only a small number of proteins of the plant and animal proteome act as allergens. Therefore, allergens have been clustered according to their common structural, biochemical and functional features. Evidence has accumulated that some allergens possess intrinsic adjuvant properties to stimulate the innate immunity. The adjuvant properties appear to contribute to the allergenicity of the respective proteins, namely the ability to cause allergic sensitization in susceptible subjects or allergic reactions in sensitized individuals. Here, we discuss how allergens interact with the innate immune cells, in particular dendritic cells and epithelial cells, via binding to pattern recognition receptors, exhibiting proteolytic activities and/or inducting type 2 innate lymphoid cells (ILC2), thereby contributing to the sensitization and development of allergic diseases.     

What is an idiotype?

Idiotypy is an important concept with significant practical implications for the manipulation of B- and T-cell clones. However, this potential depends on a correct identification of idiotypy and the development of appropriate reagents. Current knowledge of the structure and polymorphism within the Ig loci reveals that several idiotypic paradigms are based on isotypic or allotypic structures rather than supposed crossreactive idiotypes.     

Versuche an Überlebendem Carcinom-gewebe

Ohne Zusammenfassung     

Is tinnitus an acoasm?

Tinnitus and unspecific auditory hallucinations generally known as acoasms arise from identical or at least similar cerebral structures. Both phenomena can be interpreted as signs of an over activation of neuronal networks. Several pieces of evidence to underline this hypothesis as well as its implications are discussed. It is even speculated that both clinical entities might profit from treatment strategies that are normally employed for treatment of the other.     

What is an Oligodendroglioma?

With this issue, we begin a new series of articles entitled “Controversies in neuropathology.” These will represent brief position papers on controversial topics in our specialty. They are not intended to be review articles, rather will represent “position papers” on topical issues, with a relatively circumscribed and selective bibliography. Authors of these papers are encouraged to present and defend their own views on the subject in question. Most of these papers will be by invitation, but authors who would like to submit an article for this series are encouraged to contact the Brain Pathology editorial office. HVV     

Orientierungshilfen an Biopsiepräparaten

Histological findings as regards localizing a lesion suspected to be a tumor and its relation to the margins of a surgical specimen have to be as precise as possible and beyond all doubt. We report on our experience with two technical tools which are especially helpful in excisions of breast tissue: 1) Radiopaque suture material fixed intraoperatively simplifies the correlation of postoperative mammography, X-ray findings with biopsy specimens. 2) AgNO(3), as a solution or in stick form, is faster than ink or other dyes, in marking the margins in small or large surgical specimens because virtually no drying is required.     

Where does an object trigger an action? An investigation about affordances in space

A series of experiments provide evidence that affordances rely not only on the mutual appropriateness of the features of an object and the abilities of an individual, but also on the fact that those features fall within her own reachable space, thus being really ready-to-her-own-hand. We used a spatial alignment effect paradigm and systematically examined this effect when the visually presented object was located either within or outside the peripersonal space of the participants, both from a metric (Experiment 1) and from a functional point of view (Experiment 2). We found that objectual features evoke actions only when the object is presented within the portion of the peripersonal space that is effectively reachable by the participants. Experiments 3 and 4 ruled out that our results could be merely accounted for by differences in the visual salience of the presented objects. Our data suggest that the power of an object to automatically trigger an action is strictly linked to the effective possibility that an individual has to interact with it.     

Licht- und elektronenmikroskopische Untersuchungen an einem metastasierenden Dünndarmcarcinoid mit Serotoninbestimmungen an Tumorzellfraktionen

Zusammenfassung Ein Primärtumor eines Carcinoids des terminalen Ileum des Menschen wurde vergleichend licht- und elektronenmikroskopisch untersucht. Die Tumorzellen enthalten vorwiegend in den Rändern der Tumorzellkomplexe zahlreiche spezifische Granula mit einem mittleren Durchmesser vond _max=181 mµ undd _min=141 mµ. Der homogene, osmiophile, rundliche Inhalt mißt durchschnittlich 106 mµ. Das gehäufte Vorkommen der spezifischen Granula an den Rändern der Tumorzellkomplexe ist mit der diffus-granulären und starken Fluorescenz sowie der Argentaffinität der histochemischen Reaktionen identisch. Darüber hinaus finden sich in den Tumorzellen granuläre Cytosomen, die vorwiegend in Kernnähe vorkommen und ebenfalls fluorescieren sowie argentaffin sind.Tumorzellfraktionen zeigten in den kleinsten Partikelfraktionen einen stark erhöhten Serotoningehalt. Der Gesamtserotoningehalt des Tumors betrug in der Metastase 473 /g Feuchtgewicht.Mit Unterstützung der Heinrich-Hertz-Stiftung. — Assistent an der Tierärztlichen Hochschule Wien.     

Ultrasonography-based Fetal Weight Estimation: Finding an Appropriate Model for an Indian Population

Background

Very limited information is available regarding the accuracy and applicability of various ultrasonography parameters [abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and head circumference (HC)]-based fetal weight estimation models for Indian population. The objective of this study was to systematically evaluate commonly used fetal weight estimation models to determine their appropriateness for an Indian population.

Lipaemia: an overrated interference?

Reagent method sheets for analysis of common serum analytes often highlight the possibility of interference from lipaemia but the information given is often brief and may not be instrument-specific. Thus study assesses the degree of interference from lipaemia in a range of common serum analytes on the Bayer Opera (with a serum blank) using a commercial polymer, LipoClear, as a lipid-clearing agent. Serum samples (mean serum triglyceride 6.89 [range 0.58-28.4] mmol/L) are analysed for 14 common chemistry analytes and the results compared before and after treatment with LipoClear. Results showed no significant critical differences in analyte values before and after treatment, except for an expected fall in total protein, phosphate, cholesterol and triglyceride concentrations. Most of the common analytes in use on the Bayer Opera are not subject to interference from lipaemia; however, we recommend that where method sheets indicate interference from lipaemia then this should be quantified for the analyte in question.     

Is hypertension an inflammatory disease?

Hypertension has been recognized as a multi-factorial trait resulting from the effect of a combination of environmental and genetic factors, including excess dietary salt or alcohol intake, stress, age, genetics and family history, obesity, physical inactivity, as well as high saturated fat diet. During the past few years, however, a large amount of information has been collected on the vascular inflammation, indicating that inflammation may involve in the initiation as well as development of hypertension and allowing us to reconsidering the pathogenic mechanisms of hypertension. Evidence from animal models as well as patients, have indicated that hypertension, an established major risk factor for coronary artery disease, has been suggested to exert pro-inflammatory actions through the increased expression of several mediators, including leukocyte adhesion molecules, chemokines, specific growth factors, heat shock proteins, endothelin-1, and angiotensin. The association between inflammation and hypertension recalls also a similar association between low-grade inflammation and other components of the metabolic syndrome, and endothelial dysfunction as well as increased serum levels of C-reactive protein in patients with hypertension. Is hypertension an inflammatory disease? This question has stimulated research on the role of vascular inflammation in hypertension. A better understanding of the inflammatory mechanism in hypertension may, therefore, contribute to novel therapeutic strategies to decrease the morbidity as well as mortality of hypertension, and alleviated hypertensive target organ damage.     

Is autism an autoimmune disease?

Autism spectrum disorder (ASD) is a spectrum of behavioral anomalies characterized by impaired social interaction and communication, often accompanied by repetitive and stereotyped behavior. The condition manifests within the first 3 years of life and persists into adulthood. There are numerous hypotheses regarding the etiology and pathology of ASD, including a suggested role for immune dysfunction. However, to date, the evidence for involvement of the immune system in autism has been inconclusive. While immune system abnormalities have been reported in children with autistic disorder, there is little consensus regarding the nature of these differences which include both enhanced autoimmunity and reduced immune function. In this review, we discuss current findings with respect to immune function and the spectrum of autoimmune phenomena described in children with ASD.