Antigen levels and antibody titers after DNA vaccination

DNA vaccination generates strong cellular and humoral immunity in animal models. The mechanisms by which plasmid DNA uptake and expression after intramuscular injection lead to immune responses are not well understood. In particular, the importance of antigen expression levels on subsequent antibody immune responses has not been established. We found that a chemiluminescent assay for alkaline phosphatase allows measurement of antigen levels of secreted alkaline phosphatase (SEAP) in vivo after intramuscular injection of a wide range of plasmid doses. The mice produced antibodies to the alkaline phosphatase reporter gene and both antigen levels and antibody titers were measured over time. We found that the correlation between initial antigen level and antibody response was high (r = 0.74, p < 0.001) and remained high even after accounting for the dose of plasmid injected (r = 0.61, p < 0.001). The correlation between DNA dose and antibody titer was statistically significant (r = 0.53, p < 0.001) but was reduced to almost zero after we accounted for initial antigen levels.     

Mannan binding protein in sera positive for rheumatoid factor

Low levels of mannan binding protein (MBP) may protect against rheumatoid arthritis and other inflammatory conditions associated with agalactosyl IgG. MBP concentrations were measured in 99 sera found to be positive for rheumatoid factor, at least 41 of which were from patients with rheumatoid arthritis, and the values compared to the data from 352 controls. MBP was undetectable in similar proportions of patients' and control sera (4.0 and 4.3%, respectively), and low values generally were similarly distributed in the two groups. Overall, however, the patient values were distorted upwards relative to controls, consistent with an acute-phase response. These findings do not refute the proposed role for MBP-agalactosyl IgG-mediated complement activation in the pathogenesis of rheumatoid arthritis, but certainly provide no support for that hypothesis.      

Nonpharmacological treatment for migraine: incremental utility of physical therapy with relaxation and thermal biofeedback

The identification of musculoskeletal abnormalities in headache patients has led to the incorporation of physical therapy (PT) into treatment programs for chronic headache. The current studies: (i) investigated the efficacy of PT as a treatment for migraine, and (ii) investigated the utility of PT as an adjunct treatment in patients who fail to improve with relaxation training/thermal biofeedback (RTB). PT alone is not effective in reducing headache, with only 14% of subjects reporting significant headache reduction (mean reduction of 15.6% in comparison with 41.3% in RTB). However, PT may have been a useful adjunct, with 47% of a group of 11 subjects who had failed to improve with RTB reporting improvement with the addition of PT. It is recommended that RTB remain the nonmedical treatment of choice for migraine, and that PT may be a useful adjunct for patients who fail to improve after such treatment     

Low-dose flying spot digital radiography of the chest: sensitivity studies

Standard film examinations of the chest were compared with low-dose flying spot digital radiographic examinations obtained with a prototype unit in 174 patients. Analysis of pooled data from a double-blind study of 120 patients showed that film was more sensitive than digital images in the detection of pulmonary parenchymal abnormalities, that is, abnormal opacities, atelectasis, scar, and interstitial lung disease (P less than .05). Analysis of pooled data from a side-by-side study of 54 patients showed that the digital images were more sensitive than film in the detection of normal mediastinal and pleural soft-tissue contours, including the azygoesophageal recess, paraspinal line, and vertebral disk spaces (P less than .05). However, film was more sensitive than digital images in the detection of abnormalities of the lung, including scar, interstitial lung disease, septal lines, and the presence of vascular catheters (P less than .05). These findings suggest that low-dose flying spot digital radiography of the chest, as performed with this specific prototype unit, is not adequate to replace film in the detection of abnormalities of the lung parenchyma.     

Dementia in the new millennium.

Alzheimer's disease, the leading form of dementia, is expected to increase exponentially in the next 50 years. An overview of types of dementia and the typical presentation of AD are described. In addition, rationale for early assessment and methods for diagnosing the disorder are detailed.