A comparative-descriptive analysis of clinical characteristics in 2019-coronavirus-infected children and adults

Acute respiratory disease caused by 2019 novel coronavirus (2019-nCoV) has rapidly spread throughout China. Children and adults show a different clinical course. The purpose of the current study is to comparatively analyze the clinical characteristics of 2019-nCoV infection in children and adults and to explore the possible causes for the discrepancies present. The medical records of 25 adults and 7 children confirmed cases of 2019-2019-nCoV acute respiratory diseases were reviewed retrospectively. All children were family clusters. The total adult patients were differentiated into the local residents of Wuhan, a history of travel to Wuhan and direct contact with people from Wuhan. The numbers were 14 (56%), 10 (40%), and 1 (4%), respectively. The median incubation period of children and adults was 5 days (ranged, 3-12 days) and 4 days (ranged, 2-12 days), respectively. Diarrhoea and/or vomiting (57.1%) were demic by World Health Organiza more common in children, whereas for adults it was myalgia or fatigue (52%). On admission, the percentage of children having pneumonia (5%, 71.4%) was roughly the same as adults (20%, 80%). A total of 20% of adults had leucopoenia, but leukocytosis was more frequently in children (28.6%, P=.014). A higher number of children had elevated creatine kinase isoenzyme (57.1% vs 4%, P=.004). Antiviral therapy was given to all adult patients but to none of the children. In summary, knowledge of these differences between children and adults will not only be helpful for the clinical diagnosis of 2019-nCoV disease, but also for a future discussion on age-specific coronavirus infection.     

Interaction between the graft versus host reaction and pregnancy

A graft versus host reaction (GVHR) was induced in F₁(CBA×C57BL/6) female hybrids by intravenous injection of a suspension of lymphocytes from the spleen and lymph glands from C57BL/6 females. Pregnancy, which developed as a result of crossing the experimental females with syngeneic males 1–10, 10–20, 30–40, and over 40 days after injection of the lymphocytes, aggravated the transplantation sickness due to the GVHR. On the other hand, the GVHR under these conditions reduced the percentage of animals that became pregnant and disturbed the reproductive function of the experimental mice (stillbirth, death of the pregnant females, abortion). An exacerbation of the GVHR was observed in some of the experimental animals after giving birth. The rate of survival of the progeny was lowered.Department of Microbiology, Smolensk Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR N. N. Zhukov-Verezhnikov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 80, No. 9, pp. 68–71, September, 1975.     

Strain-differentiated circadian and ultradian rhythms in locomotor activity of the laboratory rat

Spontaneous locomotor activity (LA) was recorded in five inbred strains of laboratory rats (ACI/Ztm, AS/Ztm, BH/Ztm, BS/Ztm, LEW/Ztm) under light-dark (LD 1212), continuous-dark (DD), and continuous-light (LL) conditions. Strain-dependent differences in LA were observed under each light condition. Under LD conditions, 24-h rhythms were found in the LA pattern of each strain studied. In addition, the BH strain showed a clear bimodal, and the LEW strain a trimodal, activity pattern. Spectral analysis of the activity patterns revealed distinct 4- and 4.8-h ultradian rhythms in the LEW strain and 12-, 6-, 4.8-, and 4-h rhythms in the BH strain. These strain-characteristic patterns persisted under continuous-dark conditions, therefore demonstrating their endogenous character. Under continuous-bright-light conditions the circadian rhythms decreased to a non-significant level in the AS and BS strains. This was not the case, however, in all animals of the LEW and BH strains. Despite the rapid decrease in the 24-h rhythm under LL, the LEW and BH strains showed significant ultradian rhythms.This work was supported by a grant from Deutsche Forschungsgemeinschaft (SFB 146).     

Important differences in the diagnostic spectrum of primary immunodeficiency in adults versus children

Primary immunodeficiency disorders (PIDs) constitute a heterogeneous group of genetic disorders caused by defects in immunity, leading to recurrent infections, autoimmunity, lymphoproliferation and malignancies. Early diagnosis of PIDs is crucial for improving the quality of life in patients with PIDs while a delay in diagnosis, or inadequate treatment, results in an increased mortality and morbidity in affected individuals. Although most cases of PIDs present in children with recurrent and/or severe acute infections, some of the primary immune disorders are diagnosed during adulthood. Some common clues, both in children and adults, help physicians to diagnose PIDs; however, there are some specific clues to the diagnosis of PIDs for each group. This article reviews the important differences in the diagnostic spectrum of PIDs in adults versus children.     

The role of CD4CD25 T cells in autoantibody production in murine lupus

Systemic lupus erythematosus (SLE) is a chronic, systemic autoimmune disease characterized by the loss of tolerance to self-antigen. Because it is currently not known if regulatory T (T(reg)) cells are involved in the pathogenesis, we determined the frequency of CD4(+)CD25(+) T cells and assayed the related gene expression levels in CD4(+)CD25(+) T cells isolated from both lupus mice (NZB/NZW F(1)) and normal control mice (DBA2/NZW F(1)). The results showed that the frequency of CD4(+)CD25(+) T cells in lupus mice was lower than that of normal mice. Except for the high expression level of interleukin (IL)-10 mRNA, CD4(+)CD25(+) T cells from lupus mice expressed normal forkhead box P3 (Foxp3) and transforming growth factor (TGF)-beta mRNA, and exerted suppressive functions. Furthermore, we depleted CD25(+) T(reg) cells of non-autoimmune mice with anti-CD25 antibody and broke their tolerance with apoptotic cell-pulsed dendritic cells for the follow-up of autoantibody levels. The mice in the CD25(+) cell-depleted group had higher titres of anti-double-strand/single-strand DNA antibodies than those of the isotype control antibody-treated group. These findings indicated that CD4(+)CD25(+) T cells might be involved in the regulatory mechanism of autoantibody production.     

TWEAK stimulation of kidney resident cells in the pathogenesis of graft versus host induced lupus nephritis

The cytokine TWEAK demonstrates potent kidney proinflammatory and proliferative effects. Recently, we have shown that interactions of TWEAK with its receptor Fn14 are instrumental in the pathogenesis of nephritis in the chronic graft-versus-host (cGVH) induced model of lupus. Fn14 is expressed by macrophages and resident kidney cells; we hypothesized that TWEAK binding to both cell types contributes to the pathogenesis of lupus nephritis. To address this question, we generated bone marrow chimaeras and compared the progression of nephritis during cGVH induced lupus in mice expressing Fn14 only on bone marrow-derived cells, versus mice displaying Fn14 only on non-bone marrow-derived cells. While Fn14 deficiency did not significantly affect autoantibody titers, Fn14 deficiency on bone marrow-derived cells did not inhibit nephritis initiation in mice with Fn14 sufficient non-hematopoeitic cells. Conversely, expression of Fn14 only on bone marrow-derived cells resulted in a delayed, milder disease course. To further explore the role of macrophages, we depleted macrophages during cGVH induction. Surprisingly, we found that macrophage depleted mice displayed significantly increased titers of anti-DNA antibodies and worse kidney disease. We conclude that the presence of Fn14 on resident kidney cells alone may be sufficient to initiate nephritis in this murine model of lupus.     

A role for the B-cell CD74/macrophage migration inhibitory factor pathway in the immunomodulation of systemic lupus erythematosus by a therapeutic tolerogenic peptide

Systemic lupus erythematosus (SLE) is an autoimmune disease that involves dysregulation of B and T cells. A tolerogenic peptide, designated hCDR1, ameliorates disease manifestations in SLE‐afflicted mice. In the present study, the effect of treatment with hCDR1 on the CD74/macrophage migration inhibitory factor (MIF) pathway was studied. We report here that B lymphocytes from SLE‐afflicted mice express relatively elevated levels of CD74, compared with B cells from healthy mice. CD74 is a receptor found in complex with CD44, and it binds the pro‐inflammatory cytokine MIF. The latter components were also up‐regulated in B cells from the diseased mice, and treatment with hCDR1 resulted in their down‐regulation and in reduced B‐cell survival. Furthermore, up‐regulation of CD74 and CD44 expression was detected in brain hippocampi and kidneys, two target organs in SLE. Treatment with hCDR1 diminished the expression of those molecules to the levels determined for young healthy mice. These results suggest that the CD74/MIF pathway plays an important role in lupus pathology.     

The role of microparticles in the generation of immune complexes in murine lupus

Systemic lupus erythematosus is a systemic inflammatory disease characterized by antibodies to nuclear molecules in association with immune complex deposition. As shown previously, microparticles (MPs), which are small membrane-bound vesicles released from dying and activated cells, contain nucleic acids and can form immune complexes found in patient blood. To assess the role of MPs in murine lupus, we used flow cytometry to measure the presence of MPs with bound IgG in the blood of MRL-lpr/lpr and NZB/W mice. These studies showed much higher numbers of MPs with bound IgG in the blood of MRL lpr/lpr compared to NZB/W mice. Furthermore, these studies showed that antibodies from MRL-lpr/lpr mice bound better to MPs from apoptotic cells than those from NZB/W mice. Together, these studies indicate important differences in the serological features of the two strains as reflected by the capacity of antibodies to bind to MPs.     

钾通道在系统性红斑狼疮T细胞中的作用研究

目的:研究SLE患者外周血活化T细胞中Kv1.3和IKCa1通道的表达情况,以及阻断Kv1.3通道后对SLE患者T细胞增殖的影响。方法:①病例选择:SLE患者33例,健康对照组12例;②分离外周血T细胞,采用抗CD3单克隆抗体刺激T细胞活化,培养72小时;③荧光实时定量RT-PCR检测SLE患者活化T细胞中Kv1.3和IKCa1通道的mRNA表达;④CCK-8法检测阻断Kv1.3通道对SLE患者T细胞增殖的影响;⑤应用统计软件SPSS17.0进行数据统计分析;对Kv1.3和IK-Ca1通道mRNA相对表达量与补体C3、C4、抗dsDNA抗体、SLEDAI积分及尿蛋白间进行相关性分析。结果:①SLE患者外周血T细胞活化后Kv1.3通道mRNA的表达与正常对照组相比明显增高(P<0.0001),IKCa1通道mRNA的表达与正常对照组相比降低(P=0.006),SLE患者Kv1.3及IKCa1 mRNA表达水平均与补体C3、C4、抗dsDNA抗体、SLEDAI积分及尿蛋白无相关性。②Kvl.3通道阻断剂ShK可明显抑制SLE患者外周血T细胞的增殖(P<0.001)。结论:Kv1.3通过是SLE患者TEM细胞活化的主要离子通道,Kv1.3通道可成为SLE免疫治疗的一个新起点。     

系统性红斑狼疮自身抗体研究进展

经化学修饰的组织抗原,与正常组织成分有交叉反应的外来抗原、隔绝的体内自身成分及低分化的组织抗原等在一定条件下可刺激机体组织产生自身抗体.某些自身抗体因对系统性红斑狼疮(SLE)的判断具有高度特异性,已成为诊断SLE的血清指标或特异性抗体,有些自身抗体与疾病的活动性有相关性.因此,测定自身抗体有助于SLE的诊断,并对疾病的活动程度,观察治疗效果,指导临床用药具有重要的临床意义.     

CTLA-4Ig对B6.MRL-Faslpr/J狼疮小鼠脾脏Th17和Treg细胞表达的影响与其对小鼠狼疮样病征干预作用的相关性研究

目的:初步探讨B7阻断剂CD28与细胞毒T淋巴细胞相关抗原4免疫球蛋白(CTLA-4Ig)对B6.MRL-Faslpr/J狼疮小鼠脾脏Th17和调节性T细胞(Treg细胞)表达的影响与其对小鼠狼疮样病征干预作用之间的相关性。方法:将4个月龄大小雌性B6.MRL-Faslpr/J狼疮小鼠16只,随机分为观察组(Ⅰ组)和对照组(Ⅱ组),分别静脉注射CTLA-4Ig及等量PBS,检测小鼠干预前后24 h尿蛋白、ANA抗体、ds-DNA抗体及干预结束2周后血清IL-17A、脾脏中Th17细胞和Treg细胞百分比。结果:末次干预2周后Ⅰ组的24 h尿蛋白、血清ANA及ds-DNA较Ⅱ组下降均有统计学意义(均P0.05)。末次干预2周后Ⅰ组血清中IL-17A、脾脏Th17细胞比例均较Ⅱ组低,而脾脏的Treg细胞占CD4+T淋巴细胞的比例高于Ⅱ组,差异均有统计学意义(均P0.05)。结论:CTLA4-Ig具有减轻B6.MRL-Faslpr/J狼疮鼠狼疮样病征的作用;上调Treg细胞、下调Th17细胞可能是CTLA-4Ig减轻B6.MRL-Faslpr/J狼疮鼠狼疮样病征的重要机制之一。     

Children's and adults' salivary alpha‐amylase responses to a laboratory stressor and to verbal recall of the stressor

Salivary alpha‐amylase (sAA), an enzyme produced by the salivary glands, increases in response to physical and psychosocial stressors in adults. Whether similar increases are evident among children, though, is less clear, and there is a lack of studies directly comparing children's and adults' sAA responses to an identical stressor. In this study, 24 children (9–12 years; 12 female) and 26 adults (18–23 years; 16 female) were exposed to an identical psychosocial laboratory stressor and a recall interview regarding that stressor after a 2‐week delay. Saliva was collected before and 1, 10, 20, and 30 min after the stressor/recall interview. Among adults, concentrations of sAA increased on both study days, but similar increases were not detected among children. Findings suggest developmental differences in sAA reactivity, and underscore the need to characterize the confluence of elements that will reliably elicit sAA responses to mild stress in youth. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 598–602, 2010.     

The role of ophthalmic imaging in central nervous system degeneration in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder that can involve any organ system. Central nervous system involvement can be a severe life threatening complication, ultimately resulting in severe neurodegenerative changes. Magnetic resonance imaging suggests that neurodegeneration, which may have deleterious effects on brain function, may occur early in SLE and experimental models suggest that neuroprotection may be feasible and beneficial.The retina is an extension of the brain. Recent ophthalmic imaging technologies are capable of identifying early changes in retinal and choroidal morphology and circulation that may reflect CNS degeneration. However, their utility in monitoring CNS involvement in SLE has been poorly studied as these have only been performed in small cohorts, in a cross-sectional design, non-quantitatively and without correlation to disease activity.The authors aim to review the current understanding of neurodegeneration associated with SLE, with particular focus on the visual pathway. We describe the neuropathology of the visual system in SLE and the evidence for retinal and choroidal neurodegenerative and microvascular changes using optical coherence tomography technology. We aim to describe the potential role of optical imaging modalities in NPSLE diagnosis and their likely impact on the study of neuronal function.     

Performance of the 2012 Systemic Lupus International Collaborating Clinics classification criteria versus the 1997 American College of Rheumatology classification criteria in adult and juvenile systemic lupus erythematosus. A systematic review and meta-analysis

Objective

To evaluate the performance in classifying systemic lupus erythematosus by the 2012 Systemic Lupus International Collaborating Clinics criteria (SLICC’12), versus the revised American College of Rheumatology criteria from 1997 (ACR’97) in adult and juvenile SLE patients.

Prominent mucoid degeneration of the parotid gland in a patient with systemic lupus erythematosus

Lupus erythematosus (LE) can cause various cutaneous lesions including panniculitis (LE profundus), but salivary gland involvement has been extremely rare in patients with LE. Herein, we report the first documented case of systemic LE with prominent mucoid degeneration and lymphoplasmacytic infiltration in the parotid gland. A 38-year-old Japanese male with histories of autoimmune hemolytic anemia and systemic LE presented with a swelling of the bilateral cervical region. A physical examination revealed a swelling of the bilateral parotid gland and erythema of the right cheek. A biopsy specimen of the cheek demonstrated LE profundus with mucoid material deposition in the dermis. A biopsy specimen of the parotid gland showed lymphoplasmacytic infiltration and prominent mucoid material deposition within the parotid gland as well as mild lymphoplasmacytic infiltration and hyaline fat necrosis in the perisalivary tissue. Mucoid material deposition is one of the characteristic features of LE, however, this is the first case demonstrating mucoid material deposition in the salivary gland. Moreover, albeit extremely rare, lymphoplasmacytic infiltration within the lobules of the salivary gland has also been reported in patients with LE. Therefore, it is important that both lymphoplasmacytic infiltration and mucoid material deposition must be included in the differential diagnostic considerations for salivary gland tumors in patients who had been previously diagnosed as systemic or discoid LE.     

系统性红斑狼疮发病机制相关MicroRNA的研究现状

MicroRNA(miRNA)是新发现的参与高等生物基因表达调控的重要分子,很多新的证据显示miRNA在免疫功能的调控方面占据着举足轻重的地位。系统性红斑狼疮(systemic lupus erythematosus,SLE)是自身免疫性疾病的原型,它以抗核抗体为代表的自身抗体的产生、免疫复合物沉积及多系统损害为特征。SLE的发病机制长期以来是风湿免疫研究领域的难点。本文综述目前所知的与系统性红斑狼疮发病机制相关的microRNA。     

Belimumab for the treatment of systemic lupus erythematosus

Given their pivotal role in autoantibody production, B-cells have become an attractive therapeutic target in systemic lupus erythematosus (SLE). Belimumab, a fully human monoclonal antibody against B lymphocyte stimulator (BLyS), a B-cell survival factor, was licensed in 2011 for the treatment of autoantibody-positive SLE. The BLISS-52 and BLISS-76 Phase III trials successfully demonstrated that belimumab (10 mg/kg) with standard therapy significantly decreased disease activity in SLE patients compared to placebo with standard therapy. Overall, belimumab has been found to be safe and well tolerated. While the BLISS-52 and BLISS-76 studies are the largest clinical trials in SLE to date, they mainly focused on musculoskeletal, mucocutaneous, hematologic and general constitutional features of the disease. Patients with severe lupus nephritis and severe central nervous system disease were excluded from these trials. Studies of belimumab in lupus nephritis are ongoing that may clarify the role of this agent in the clinical management of SLE.