Blood aqueous barrier permeability versus age by fluorophotometry

Values of the diffusion coefficient into the anterior chamber and the blood aqueous barrier permeability as a function of age were determined by fluorophotometry in 58 healthy volunteers. The diffusion coefficient was calculated from aqueous fluorescein concentration and the time integral of non-protein bound fluorescein concentration in plasma. Blood-aqueous barrier permeability was calculated using diffusion coefficient values, the area of fluorescein inflow into the anterior chamber and anterior chamber volume. Values for diffusion coefficient as well as permeability were found to be independent of age between 13 y and 72 y (lin. corr. coeff. 0.2, p = 0.11) mean values were 4.7 .10(-4) min-1 +/- 1.5. 10(-4) SD and 15.4 nm/s +/- 4.8 SD, respectively. The difference between permeability values calculated from fluorophotometric scans at 30, 55 and 65 mins. after fluorescein injection was less than 5% and the 7 months reproducibility was within 15%. There was no significant correlation between simultaneously measured values of blood-retinal and blood-aqueous barrier permeability (lin. corr. coeff. 0.13, p = 0.4).     

Interaction of indomethacin with cytokine production in whole blood. Potential mechanism for a brain-protective effect

Both Alzheimer's disease and vascular dementia are featured by inflammatory responses and it is known that non-steroidal anti-inflammatory drugs (NSAIDs) decrease the risk and severity of these diseases.To study the effect of NSAIDs on PGE2 levels and pro- and anti-inflammatory cytokine levels in the whole blood assay, blood samples from 23 elderly persons aged 85 years were stimulated with thrombin or LPS as primary stimulus. Indomethacin was added in concentrations ranging from 0.4 to 16 microg/ml and acetylsalicylic acid was added to in concentrations ranging from 0.5 to 8.0 microg/ml.Indomethacin abrogated thrombin- and LPS-induced PGE2 production at all concentrations tested. In addition, indomethacin reduced the production of thrombin-induced IL-6 and IL-10 (p<0.05) at physiological concentrations. Indomethacin reduced the production of LPS-induced IL-6, IL-1 beta and IL-10 (p<0.05) at the highest indomethacin concentration tested. Similar results were obtained upon incubation with acetylsalicylic acid.It is concluded that indomethacin may reduce the thrombin-induced inflammatory reaction by decreasing IL-6 through inhibition of PGE2 synthesis. This IL-6 reduction may be relevant for the ability of indomethacin to reduce the risk of Alzheimer's disease. However, the decrease in IL-10 production due to indomethacin suggests a more inflammatory state.     

Accelerated platelet reconstitution following transplantation of bone marrow cells derived from IL-6-treated donor mice

 We transplanted bone marrow cells derived from normal donor mice treated with IL-6 to study the effect on the hematopoietic recovery of lethally irradiated (8.5 Gy) recipients. Male Balb/C mice were treated for 7 days by continuous infusion of IL-6 (10 μg/day). Not only did these donor mice have increased numbers of circulating platelets as was previously shown; the numbers of circulating progenitor cells also increased more than 25-fold. Transplantation of nucleated bone marrow cells derived from these donor mice into lethally irradiated female recipients resulted in increased platelet nadir counts in comparison to recipients of normal bone marrow cells and similar to nadir counts of recipients of normal donor bone marrow treated with IL-6 for 7 days after transplantation. Combination of transplantation of bone marrow derived from IL-6 treated donors with post-transplantation treatment of the recipients with IL-6 resulted in a further increase in nadir counts, although it did not cause a further acceleration of platelet reconstitution. We conclude that transplantation of bone marrow cells modified in vivo by IL-6 results in significantly accelerated reconstitution of platelets, to a degree similar to that observed following treatment with IL-6 after transplantation. Received: 6 June 1996 / Accepted: 3 July 1996     

Patients with Alzheimer's disease display a pro-inflammatory phenotype

BACKGROUND: Inflammation plays a pivotal role in amyloid plaque progression thereby contributing to Alzheimer's disease-related neurodegeneration. We hypothesized that patients with Alzheimer's disease have an innate pro-inflammatory phenotype, as compared to control subjects without dementia. METHODS: Patients with a diagnosis of probable Alzheimer's disease (n=12) and control subjects without signs of dementia (n=18) were enrolled. Whole blood samples were stimulated ex vivo with endotoxin under standard conditions. Cytokine levels were assessed by ELISA and compared by Mann-Whitneyll-test after log transformation. RESULTS: Patients with Alzheimer's disease had seven- to ten-fold higher IL-1beta production relative to the amount of IL-10 both at the low (p=0.006) and high concentration of endotoxin (p=0.007). Subjects who display a pro-inflammatory phenotype as defined by a high IL-1beta/IL-10 ratio had 13.0-fold higher odds (95% CI: 2.1-82) to have dementia. CONCLUSION: The data support the hypothesis that a pro-inflammatory phenotype contributes to the development of Alzheimer's disease.     

Pro-poor health policies in poverty reduction strategies

Since 1999, the International Monetary Fund and World Bank have required low-income countries soliciting for debt relief and financial support to prepare a Poverty Reduction Strategy Paper (PRSP). The objective of this study is to arrive at a systematic assessment of the extent to which the first batch of interim PRSPs actually addresses the health of the poor and vulnerable. A literature study was used to design and test a semi-quantitative approach to assess the pro-poor focus of health policies in national documents. The approach was applied to the existing interim proposals for 23 Highly Indebted Poor Countries. Results show that a majority of proposals lack country-specific data on the distribution and composition of the burden of disease, a clear identification of health system constraints and an assessment of the impact of health services on the population. More importantly, they make little effort to analyze these issues in relation to the poor. Furthermore, only a small group explicitly includes the interests of the poor in health policy design. Attention to policies aiming at enhancing equity in public health spending is even more limited. Few papers that include expenditure proposals also show pro-poor focused health budgets. We conclude that our systematic assessment of a new international development policy instrument, PRSP, raises strong concerns about the attributed role of health in development and the limited emphasis on the poor, the supposed primary beneficiaries of this instrument. There is a need and an opportunity for the international development community to provide assistance and inputs as poor countries shift their policy thinking from an interim stage to fully developed national policies. This paper presents a menu of analytical and policy options that can be pursued.