Función efectora de linfocitos T CLA+ sobre queratinocitos autólogos en psoriasis

BackgroundCutaneous lymphocyte antigen (CLA) is expressed by a subgroup of memory T cells that exhibit skin homing and are implicated in cutaneous T-cell-mediated diseases.Material and methodsExpression of genes associated with psoriasis was analyzed in keratinocytes taken from patients and healthy individuals and cultured under different conditions, including activation using supernatants from CLA⁺ T lymphocytes activated with anti-CD3 and anti-CD28 antibodies.ResultsKeratinocytes from psoriasis patients activated by CLA⁺ T lymphocytes expressed higher levels of interferon-inducible protein 10, HLA-DR, intercellular cell adhesion molecule 1, and inducible nitric oxide synthase.ConclusionsOur results suggest that we have developed an in vitro model that will allow analysis of the effector role of CLA⁺ T lymphocytes on keratinocytes in psoriasis. This model may allow the identification of genes involved in the pathology of psoriasis through induction by CLA⁺ T lymphocytes.     

Preterm birth and exposure to air pollutants during pregnancy

Background

Research has shown that prenatal exposure to air pollutants may have a detrimental effect on fetal development, with the strength of the relationship depending on the effect being studied. The evidence to date, however, is insufficient to establish a direct causal link between such exposure and preterm delivery. This study evaluates the specific effect of prenatal exposure to NO₂ and benzene on preterm births.

Methods

The population under study comprised 785 pregnant women who formed part of the INMA cohort in Valencia, Spain (2003–2005). Multiple regression models were used for mapping outdoor nitrogen dioxide (NO₂) and benzene levels throughout the area. Individual exposure was assigned as the estimated outdoor levels at each woman’s home measured during each trimester as well as throughout the entire pregnancy. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated in order to assess the association between preterm birth and exposure to NO₂ and benzene. The shape of the exposure–response curve between air pollution and the risk of preterm birth was analyzed with a flexible approach, introducing a natural cubic spline for air pollution levels into the model.

Results

Pregnant women exposed to NO₂ and benzene have an increased risk of preterm birth. This risk was shown to be significant when women were exposed to NO₂ levels >46.2 μg/m³ during the second and third trimesters as well as throughout the entire pregnancy and to benzene levels >2.7 μg/m³ throughout the entire pregnancy.

Conclusion

These results suggest that maternal exposure to traffic-related air pollution is associated with preterm birth.     

Effectiveness of Nintendo Wii and Physical Therapy in Functionality,Balance, and Daily Activities in Chronic Stroke Patients

ObjectivesThe aim of this study was to assess whether a virtual rehabilitation program using Nintendo Wii added to conventional physical therapy improved functionality, balance, and daily activities in chronic stroke survivors, when compared with conventional physical therapy.DesignWe undertook a randomized controlled clinical trial. The participants of this study were randomized to 2 groups: (1) conventional physical therapy (CPTG), which included exercises related to functionality, balance, and activities of daily living; and (2) virtual reality with Nintendo Wii (VRWiiG), which included balance training with the Wii Balance Board and upper limb exercises with the Wii Sports package, added to conventional physical therapy.Setting and ParticipantsThis study was conducted in a university rehabilitation clinic and 29 stroke survivors were admitted.MethodsBoth interventions lasted 4 weeks, 2 sessions per week. Assessments were performed at baseline and at the end of the study, including functionality [Timed up and go (TUG)], balance [Tinetti Performance-Oriented Mobility Assessment (POMA)], Berg Balance Scale (BBS), and activities of daily living [Fugl-Meyer Upper Limb Motor Assessment, Barthel Index, Frenchay Activity Index (FAI)].ResultsRegarding TUG, POMA, and BBS, the analysis of variance showed significant differences for time and group1time interaction. Post hoc analysis showed between-group differences (P = .044, d = ?0.78; P = .012, d = 1.00; P = .042, d = 0.79, respectively) and within-group differences only in the VRWiiG (P < .001, d = 0.75; P < .001, d = ?0.76; P < .001, d = ?0.57, respectively). Regarding activities of daily living, post hoc analysis showed within-group differences only in VRWiiG.Conclusions and ImplicationsOur study showed promising results in functionality, balance, and activities of daily living when adding virtual reality with Nintendo Wii to conventional physical therapy in chronic stroke survivors. All procedures were approved by the Human Research Ethics Committee of the University of Valencia (H1518177391901). ClinicalTrials.gov database (NLM identifier NCT04144556).     

Cytokine-related syndrome following injection of anti-CD3 monoclonal antibody: further evidence for transient in vivo T cell activation

In vivo injection of the hamster anti-murine CD3 monoclonal antibody 145 2C11 into BALB/c mice induces a massive systemic release of several cytokines. Very high circulating levels of tumor necrosis factor are detected both by enzyme-linked immunosorbent assay and L-929 bioassay 90 min following a single injection of 10 micrograms/mouse 145 2C11. Peak circulating levels of exclusively T cell-derived products such as interferon-gamma, interleukin 2 and interleukin 3 are also detected 90 min to 8 h post-injection. Importantly, this cytokine release is transient since none of these cytokines are still present 12 to 24 h post-injection. In parallel to cytokine release, 145 2C11-treated mice (10 micrograms/mouse) exhibit somnolence, hypomotility (quantified by actimetry), hypothermia, diarrhea and piloerection. At this dosage, the physical reaction is not lethal and reverses in all mice by 48 h post-injection. Severe but again reversible anatomopathological changes are also observed: massive cellular depletion, necrosis and edema of lymphoid organs, leakage syndrome and inflammatory cell infiltrates of the lung, cell vacuolization, necrosis and vascular congestion of the liver. All these data are similar to the clinical and immunological manifestations of the OKT3-induced reaction in patients and, thus, provide an invaluable experimental tool to study its mechanisms and explore its prevention.     

Children’s Subjective Well-Being Measured Using a Composite Index: What Impacts Spanish First-Year Secondary Education Students’ Subjective Well-Being?

This paper presents data from a representative Spanish sample of children (N?=?5934) in the first year of compulsory secondary education. Data were collected using four different psychometric instruments for measuring adolescents’ self-reported well-being, and a series of questions on children’s objective life situations, and another set of questions that explored respondents’ opinions, perceptions and evaluations. All the items were translated into the four different co-official languages in the different autonomous regions and cities that compose Spain. Three of the psychometric instruments used as indicators of subjective well-being are widely-known and have been used on adolescent populations in different countries; they have also been validated in the Spanish context in previous research. One (the SLSS) was specifically designed for children and adolescents aged 8 to 18. Another (the PWI) was initially designed for adults, but has been used with adolescents in different countries, and previous results suggest it is well understood and performs well with populations aged 12–18. The third well-known instrument used is a single-item scale on overall life satisfaction. The fourth instrument comprises an additional list of items on satisfaction with different aspects or domains in children’s lives. A composite synthetic Index, the GICSWB (General Index of Children’s Subjective Well-Being), was calculated using the values resulting from these psychometric instruments. The results of this Index are presented, showing different situations and perceptions in children’s lives that are related to significantly lower subjective well-being among the children involved when compared to those not involved in the same situations or perceptions.     

Functional decline after prolonged bed rest following acute illness in elderly patients: Is trunk control test (TCT) a predictor of recovering ambulation?

Authors wanted to assess the predictive value of the trunk control test (TCT) on recovering ambulation in elderly patients who have developed walking disability. The study design was a prospective study performed in a hospital-based intermediate-care unit. Twenty-one patients (mean age 78.5 ± 6.7 years) were investigated, who had developed walking disability after prolonged bed rest for an acute condition. A comprehensive geriatric assessment with functional status evaluation, based on the activities of daily living (ADL) (expressed as Barthel index = BI), and instrumental activities of daily living (IADL) (expressed as Lawton index = LI), cognitive function (Mini-Mental State Examination-Folstein = MMSE), depression (Geriatric Depression Scale = GDS) and comorbidity (Charlson comorbidity index = CCI) was performed within 72 h after admission. A specialist in physical medicine and rehabilitation designed a rehabilitation program. TCT was performed in all patients before they started the program. The mean TCT score of the 21 patients was 52.7 ± 22.9 (range: 0–100), while this score was 47.3 ± 16.9 in the 15 patients who recovered ambulation, and 66.2 ± 31.4 in the rest who did not (p = 0.08). No statistically significant differences were observed either in subtotal scores of the TCT between groups. Furthermore, none of the TCT cutoff point was significantly associated with recovery. Cognitive function assessed by the MMSE was significantly better in patients who recovered, than in those who did not (23.4 ± 3.9 vs. 17.8 ± 5.2; p < 0.02). Our conclusion is that TCT has not proved to be a predictor of recovering ambulation in elderly patients. In the present study, cognitive function was significantly associated with recovery after prolonged bed rest.