Modulation of intracellular expression of IFNγ and IL-2 in culture of splenic T lymphocytes by some flavonoid glycosides of Alchornea floribunda

Context Alchornea floribunda Müll. Arg. (Euphorbiaceae) leaves are widely used in ethnomedicine for the management of rheumatism, arthritis and toothache.

Objective In this study, flavonoid glycosides isolated from Alchornea floribunda were screened for their effect on the intracellular expression of interferon-gamma (IFNγ) and interleukin-2 (IL-2) type-1 cytokines.

Materials and methods Chromatographic purification of the ethyl acetate fraction of the methanol leaf extract led to the isolation of seven flavonoid glycosides (1–7). Their structures were elucidated by 1D and 2D nuclear magnetic resonance and mass spectrometry. Splenocytes were treated with graded concentrations of the compounds (6.25–25?μg/mL) and incubated for 24?h. Thereafter, their effect on the expression of IFNγ and IL-2 by CD4^+?and CD8^+?T-lymphocytes was evaluated using intracellular cytokine staining and FACS analysis.

Results Compounds 1–7 (6.25–25?μg/mL) caused the up-regulation of activated CD8^+?(57.85–72.45% versus 57.85% for untreated control) and, to a lesser extent, activated CD4^+?(3.21–7.21% versus 2.75% for the untreated control) T-lymphocytes that were both largely interferon-gamma-releasing in treated mouse T lymphocytes relative to untreated control. FACS data analysis showed that stimulation with all the compounds increased the proportion of CD8⁺/IFNγ^+?and CD4⁺/IFNγ^+?T lymphocytes up to two-fold when compared with the cells in untreated control wells. Intracellular IL-2 secretion by treated T cells was not detected.

Conclusion This recorded T-lymphocyte-specific immune-modulatory property may contribute to explain in part the dynamics associated with the ethnomedicine of Alchornea floribunda, and may find relevance as a necessary cellular immune response precursor to infection-associated disease management.     

Adolescent disc dysplasia and back pain

Purpose  

Adolescent disc dysplasia can be a cause of significant back pain and functional impairment in patients. We present a case series of patients inflicted with adolescent disc dysplasia (ADD).     

Comparison of outcomes between operative vaginal deliveries and spontaneous vaginal deliveries in southeast Nigeria

Objective

To evaluate the incidence of, indications for, and outcome of operative vaginal deliveries compared with spontaneous vaginal deliveries in southeast Nigeria.

Methods

A retrospective cohort study was conducted involving cases of operative vaginal delivery performed at Ebonyi State University Teaching Hospital over a 10-year period. Data on the procedures were abstracted from the operation notes of the medical records of parturients.

Results

An incidence of 4.7% (n = 461) was recorded. The most common indications for vacuum and forceps delivery were prolonged second stage of labor (44.9%) and poor maternal effort (27.8%). The only indication for destructive operation was intrauterine fetal death (3.7%). The risk ratio (RR) for hemorrhage/vulvar hematoma was 1.14 (95% confidence interval [CI], 0.53–2.48) for vacuum-assisted delivery and 5.49 (95% CI, 0.82–36.64) for forceps delivery. The RR for genital laceration was 1.21 (95% CI, 0.44–3.30) for vacuum-assisted delivery and 9.41 (95% CI, 1.33–66.65) for forceps delivery. The risk of fetal scalp bruises and caput succedaneum was higher for operative vaginal delivery than for spontaneous vaginal delivery, with no significant difference in maternal morbidity. The perinatal mortality rate was 0.9 per 1000 live births.

Conclusion

Operative vaginal delivery by experienced healthcare providers is associated with good obstetric outcomes with minimal risk.     

Membrane stripping to prevent post-term pregnancy in Enugu, Nigeria: a randomized controlled trial

Objectives

This study aimed at evaluating the effectiveness and safety of membrane stripping at 40–41 weeks of gestation as a means of preventing post-term pregnancy and the need for formal induction of labor in Enugu, Nigeria.

Methodology

A randomized controlled trial of 134 post-date pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria, from February to November 2012. The intervention group received membrane stripping while the control group did not receive membrane stripping.

Results

The incidence of post-term pregnancy in the membrane stripping group was 16.1 % (10/62) versus 39.3 % (24/61) in the control group (RR 0.41; 95 % CI 0.22–0.78; P = 0.004; NNT = 4). Membrane stripping reduced the duration of pregnancy by 3 days (P < 0.001). The procedure also significantly reduced the need for ‘formal’ labor induction [7/62 (11.3 %) vs. 23/61 (37.7 %); RR 0.30; 95 CI 0.14–0.65; P = 0.002]. However, maternal and neonatal complications were similar between the two groups.

Conclusion

Membrane stripping reduces the incidence of post-term pregnancy and need for formal induction of labor in post-date pregnant women, without increased maternal or neonatal complications.     

A therapeutic DNA vaccination strategy for autoimmunity and transplantation

De novo autoimmunity induced by an allograft may play a significant role in chronic organ rejection, which remains a major barrier to successful transplantation. Accordingly, immunization with non-polymorphic antigens found in both donor allograft and recipient would be an attractive means to prevent long-term graft rejection, because it would rely on recipient mechanisms of immune homeostasis and could minimize the need to identify appropriate donor polymorphic antigens for induction of graft tolerance. Here we show that intradermal injection of plasmid DNA encoding glutamic acid decarboxylase (GAD) polypeptide, which is synthesized in both pancreatic islet and skin tissue, ameliorated new-onset type 1 diabetes in NOD mice and increased skin allograft survival in a BALB/c-C57BL/6 model system in a donor-specific manner. Successful therapy of autoimmune diabetes required CpG-methylation of plasmid DNA and co-delivery of a cDNA coding for the pro-apoptotic BAX protein, which was shown previously to induce Foxp3⁺ regulatory T cells in NOD mice. In contrast, significantly increased skin allograft survival after immunization of recipient only required CpG-methylation of plasmid DNA coding for GAD alone. Injection of unmethylated plasmid DNA coding for BAX alone near the allograft also promoted graft survival, but induced a pro-inflammatory response to self-antigens. Our results reveal a promising potential for autoimmunity-targeting DNA vaccination to be applied to transplantation.