Cytokines and apoptotic molecules in experimental melanin-protein induced uveitis (EMIU) and experimental autoimmune uveoretinitis (EAU).

The cytokine profile and occurrence of apoptosis during experimental melanin-protein induced uveitis (EMIU) were investigated and compared with that of experimental autoimmune uveoretinitis (EAU). EMIU or EAU was induced in Lewis rats. Eyes were collected at different time points after immunization. Cytokine mRNA expression was identified in the inflammatory cells in the uvea of EMIU rats; IL-2, IFN-gamma and IL-12 increased at the peak of the inflammation, and then tapered off as inflammation subsided. IL-4 and IL-10 increased at the peak of ocular inflammation, and persisted with inflammation resolved. Fas and FasL were expressed consistently in ocular resident cells of EMIU, but were elevated in EAU. In EAU, Bcl-2 expression showed a sharp peak in inflammatory cells but not in the resident cells. In EMIU, high levels of Bcl-2 were present and persisted in both ocular resident and inflammatory cells. Expression of Bax was relatively stable in both EAU and EMIU. Cellular DNA fragmentation was detected in the retinal glial cells of EAU and some inflammatory cells of EMIU. In EMIU, the dynamics of Th1 cytokines were consistent with the ocular inflammation, whereas persistent expression of Th2 cytokines was consistent with their known regulatory role. The continuous high expression of Bcl-2 and the high ratio of Bcl-2 to Bax in the eyes of EMIU may possibly contribute to prevention of ocular tissue damage, and of inflammatory cells from undergoing apoptosis, thus resulting in chronic recurrent inflammation.     

Increased CD4+ T cell infiltrates in rheumatoid arthritis–associated interstitial pneumonitis compared with idiopathic interstitial pneumonitis

Objective

To study lymphocyte markers in rheumatoid arthritis (RA)–associated interstitial pneumonitis (IP) compared with idiopathic IP.

Methods

Paraffin‐embedded lung biopsy specimens from patients with RA (n = 15) and from those without RA (n = 16), all of whom had a diagnosis of either nonspecific IP or usual IP, were studied. Tissue sections from each patient were reviewed by a pathologist, who was blinded to the clinical data. Age and pulmonary function test results were similar in RA and non‐RA patients. After high‐temperature antigen unmasking, sections were incubated with mouse monoclonal antibodies directed against CD3, CD4, CD8, CD16, and CD20. All slides were coded, and digital images (100× magnification) of the entire tissue area were obtained. Staining was quantified using computer‐assisted image analysis.

Results

Staining for CD4 was more prominent in patients with RA than in the non‐RA comparison group (median 9.3 cells/mm², interquartile range [IQR] 5.5–27.3 versus 0.6 cells/mm², IQR 0.2–1.9; P = 0.002). CD4+ cell counts were increased in RA patients with nonspecific IP as well as in RA patients with usual IP, with no major difference between these groups. Results were similar for quantification of CD3 (P = 0.012). There was a less striking trend toward more CD8+ cells in RA patients (P = 0.27 versus those with non‐RA lung disease).

Conclusion

IP lesions in patients with RA are characterized by an increased number of CD4+ cells, as compared with that in patients with idiopathic IP. This finding suggests that CD4+ T cells are critical for the development of pulmonary manifestations in RA, and may have implications for the treatment of RA‐associated lung disease.

     

黄芩苷下调NF-κB表达抑制高糖环境下肾小球系膜细胞增殖的作用

目的研究黄芩苷对高糖环境下肾小球系膜细胞（GMC）增殖的抑制作用及对NF-κB表达的影响。方法将体外培养的大鼠GMC分为六组：低糖组,高糖组,黄芩苷低、中、高剂量组、氯沙坦组,培养24、48、72 h。实验结束后根据MTT法检测结果,收集细胞并提取核蛋白,用Western blot方法检测各组NF-κB表达情况。结果高糖组在24、48、72 h时间段的吸光值均较低糖组增高,且随培养时间延长而增高明显（P〈0.05）;黄芩苷低、中、高剂量组,氯沙坦组在24 h时间段吸光值均较高糖组高,48、72 h时间段较高糖组低（P〈0.05）。Western blot结果显示,高糖组NF-κB表达量较低糖组增加。而用黄芩苷干预后,GMC中NF-κB表达量较高糖组减少,且随着浓度增加,表达量逐渐减少。结论高糖环境下体外培养的GMC存在异常增殖现象,黄芩苷能抑制高糖诱导的GMC异常增殖,且呈时间、剂量依赖关系,其机制可能与黄芩苷下调NF-κB表达有关。     

Hangman's fracture: radiologic assessment in 27 cases

Traumatic spondylolisthesis of C-2, frequently referred to as the hangman's fracture, is typically regarded as a hyperextension injury with rare neurologic sequelae by virtue of decompression of the neural canal. The authors retrospectively evaluated their radiographic experience with this injury in 27 patients over a 24-month period. Lateral cervical spine studies and computed tomography (CT) scans (21 patients) were analyzed. CT studies provided better delineation of the fracture in all 21 patients and significant additional information in five patients (24%). Seven patients (26%) suffered initial neurologic sequelae in association with the C-2 injury. Nine patients had additional sites of fracture, including seven with associated C-1 ring disruption (26%). Extension of the fracture line into the transverse vertebral artery foramen led to vertebral artery injury and cerebellar embolization in one patient. Angiography may be necessary to detect intimal injury to the vertebral arteries when the fracture extends through the transverse foramina and to indicate the need for anticoagulation when clinically feasible.