Effects of interferon-α on cytokine profile,T cell receptor repertoire and peptide reactivity of human allergen-specific T cells

A large panel of T cell clones (TCC) specific for the recombinant form of Poa pratensis allergen (rKBG7.2 or Poa p9) were established from the peripheral blood of a grass pollen-sensitive donor in the absence or presence of recombinant interferon-α (IFN-α) in bulk culture and their pattern of cytokine secretion, peptide reactivity and TCR Vβ repertoire was examined. The majority of allergen-specific TCC derived in absence of IFN-α produced high amounts of interleukin-4 (IL-4) and IL-5 but not IFN-γ (Th2 cells), while most of TCC derived in presence of IFN-α produced IFN-γ but not, or limited amounts of, IL-4 and IL-5 (Th1 or Th0 cells). Of 24 TCC established in the presence of IFN-α, 22 were able to recognize a single allergen peptide, p26, while none of the clones established in the absence of IFN-α showed a similar specificity. The majority of both clones expressed the Vβ2 element regardless of whether they were established in the presence of IFN-α, but the presence of IFN-α favored the expansion of Vβ2⁺, Vβ17⁺ and Vβ22⁺ Poa p9-specific T cells, whereas in the absence of IFN-α, other TCR Vβ-bearing T cells (Vβ5, Vβ6.7 and Vβ14) were expanded in addition to Vβ2⁺ T cells. None of Vβ2⁺ clones established in the absence of IFN-α reacted with p26, whereas all the Vβ2⁺ clones established in its presence responded to this peptide. IFN-α also shifted the TCR Vβ repertoire of both Poa p9- and Lolium perenne group 1 (Lol p1)-specific T cell lines generated from the same patient and from a different grass-sensitive individual. These data demonstrate that IFN-α modulates the development of allergen-specific T cells in vitro, and suggest that IFN-α may represent an useful tool for novel immunotherapeutic approaches in allergic disorders.     

Neurotrophins: a link between airway inflammation and airway smooth muscle contractility in asthma?

BACKGROUND: Bronchial asthma (BA) is characterized by a unique type of airway inflammation, epithelial cell damage and increased airway smooth muscle (ASM) contractility. The regulatory network between the immunological events and the neuronal control of ASM contractility remains to be defined. METHODS: Utilizing a well-characterized mouse model of airway inflammation and BA, we analyzed the production and function of neurotrophins in allergic asthma. To confirm these data in humans, segmental allergen provocation was performed in mild asthmatics. RESULTS: Allergen-induced airway inflammation was associated with increased local production of the neurotrophins nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in mice as well as in humans. In bronchoalveolar lavage fluid (BALF), NGF levels were increased 4- to 5-fold in men and mice 1 day after allergen provocation. The increase in BDNF was about 2-fold in both models. Treatment of mice with anti-NGF prevented development of airway hyperresponsiveness (AHR). In the human study group, NGF levels in BALF after allergen provocation were correlated significantly with baseline FEV1 levels. CONCLUSION: These data strongly suggest that neurotrophins serve as a link between airway inflammation and neuronal control of ASM constriction in BA.     

T cell receptor vbeta repertoire in bronchoalveolar lavage in Wegener's granulomatosis and sarcoidosis.

BACKGROUND: Lymphocytic alveolitis is a common feature of Wegener's granulomatosis (WG) and sarcoidosis. In pulmonary sarcoidosis analysis of the T cell receptor (TCR) configuration disclosed a biased TCR repertoire in cells obtained by bronchoalveolar lavage (BAL), suggesting that the pulmonary T cell population contains an oligoclonal, probably antigenically selected component. We examined whether this is also a feature of WG. METHODS: The distribution of 16 TCR Vbeta phenotypes on BAL cells was compared with the distribution on autologous blood cells in 8 WG patients with lymphocytic alveolitis. A control group was composed of 5 patients with active pulmonary sarcoidosis. The two groups were comparable with respect to the lymphocyte count in BAL and the distribution of the CD4+ and CD8+ T cell subsets in BAL and the blood. Overutilization of individual Vbeta phenotypes on BAL cells was considered to be significant when the percentage of positive cells in BAL doubled than in the blood and the frequency in BAL was at least 10% of total BAL T cells. RESULTS: All 5 sarcoidosis patients showed substantial overutilization of individual Vbeta families in BAL as compared with the blood. By contrast, only 2 of the 8 WG patients showed overutilization of individual Vbeta phenotypes in BAL. CONCLUSIONS: These findings do not suggest that the T cell population in BAL of WG patients contains a prominent oligoclonal component. While BAL is a convenient approach to obtain T cells from a site of active disease, BAL cells do not appear to be good material for the isolation of clonally selected T cells in WG.     

Effects of a low-molecular-weight CCR-3 antagonist on chronic experimental asthma

Eosinophils represent one of the main effector cell populations of allergic airway inflammation and allergic bronchial asthma. Their infiltration correlates with many characteristics of the disease, including airway hyperresponsiveness (AHR) and increased mucus production. CCR-3 is the principle chemokine receptor involved in eosinophil attraction into inflamed tissue. Therefore, antagonizing CCR-3 could be a novel promising approach toward asthma therapy. We investigated the effect of a low-molecular-weight CCR-3 antagonist on established airway inflammation in a chronic model of experimental bronchial asthma. For this purpose, BALB/c mice intraperitoneally sensitized with ovalbumin (OVA) were chronically challenged with OVA aerosol to induce chronic airway inflammation and airway remodeling. The effect of antagonizing CCR-3 on asthma pathology was examined in BAL and lung histology. Airway reactivity was assessed by head-out body plethysmography. Treatment with the CCR-3 antagonist resulted in a marked reduction of eosinophils in the bronchoalveolar lumen and in airway wall tissue, whereas infiltration of lymphocytes or macrophages remained unchanged. The reduction in eosinophil infiltration was accompanied by normalization of AHR and prevention of goblet cell hyperplasia, indicating reduced mucus production. Furthermore, antagonizing CCR-3 prevented airway remodeling as defined by subepithelial fibrosis and increased accumulation of myofibrocytes in the airway wall of chronically challenged mice. These data demonstrate that antagonism of CCR3 reduces eosinophil numbers, which is accompanied by diminution of asthma pathology in a mouse model of established chronic experimental asthma. Therefore, antagonizing CCR-3 represents a new approach toward a promising asthma therapy.     

Airway expression of calcitonin gene-related peptide in T-cell peptide-induced late asthmatic reactions in atopics

BACKGROUND: The mechanisms of late asthmatic reactions provoked in atopic asthmatics by allergen-derived T-cell peptide epitopes remain unclear. Previous studies showed no changes in airway eosinophils or mast cell products after peptide challenge. In the present study our aim was to measure calcitonin gene-related peptide (CGRP), neurokinin (NK)-A, and substance P (SP) in bronchoalveolar lavage fluid and bronchial biopsies (BB) after inhalation of allergen-derived T-cell peptide epitopes since these neuropeptides (NP) had not previously been evaluated in this chronic asthma model. METHODS: Bronchoscopy, with BB and bronchoalveolar lavage (BAL), was performed in 24 cat-allergic subjects 6 h after inhalation of Fel d 1-derived peptides. Neuropeptides were measured in BAL by enzyme-linked immunosorbent assay and CGRP expression in the airways was assessed by immunohistochemistry and confocal microscopy. RESULTS: Twelve subjects (termed 'responders') developed isolated late reactions. Calcitonin gene-related peptide, but not NK-A or SP, was significantly elevated in BAL in responders only. Biopsy studies showed that in virtually all responders peptide challenge induced marked increases in CGRP immunoreactivity in bronchial epithelial cells, infiltrating submucosal cells and in association with airway smooth muscle. Double immunostaining indicated that CGRP colocalized predominantly to CD3+/CD4+ and CD68+ submucosal inflammatory cells. CONCLUSION: Calcitonin gene-related peptide, a potent vasodilator, is markedly up-regulated in the airways of atopic asthmatics during late-phase reactions provoked by inhalation of allergen-derived T-cell peptides.     

Development of an instrument for the identification of frail older people as a target population for integrated care

Background

Primary care is increasingly interested in the identification of frailty, as it selects the target population for integrated care. However, instruments for the identification of frailty specifically validated for use in primary care are scarce. This study developed the Easycare Two-step Older persons Screening (Easycare-TOS), which provides a valid, efficient, and pragmatic screening procedure to identify frail older people.

Aim

This paper aims to describe the development of the Easycare-TOS and the data from the pilot studies.

Design and setting

Observational pilot study in seven academic GP practices in and around Nijmegen, The Netherlands.

Method

The Easycare-TOS was developed in a cyclic process with the input of stakeholders. In every cycle, the requirements were first defined, then translated into a prototype that was tested in a pilot study. The Easycare-TOS makes optimal use of prior knowledge of the GP, and the professionals’ appraisal is decisive in the frailty decision, instead of a cut-off score. Further, it considers aspects of frailty, as well as aspects of the care context of the patient.

Results

The pilot data have shown that after step 1, two-thirds of the patients do not need further assessment, because they are judged as not frail, based on prior knowledge of the GP. The overall prevalence of frailty in this pilot study is 24%. Most professionals who participated in the pilot studies considered the time investment acceptable and the method to be of added value.

Conclusion

The Easycare-TOS instrument meets the predefined efficiency, flexibility, and acceptability requirements for use as an identification instrument for frailty in primary care.     

Contribution of microRNA 24–3p and Erk1/2 to interleukin‐6‐mediated plasma cell survival

Plasma cells can survive for long periods and continuously secrete protective antibodies, but plasma cell production of autoantibodies or transformation to tumor cells is detrimental. Plasma cell survival depends on exogenous factors from the surrounding microenvironment, and largely unknown intracellular mediators that regulate cell homeostasis. Here we investigated the contribution of the microRNA 24–3p (miR‐24–3p) to the survival of human plasma cells under the influence of IL‐6 and SDF‐1α (stromal cell derived factor 1), both of which are bone marrow survival niche mediators. Deep sequencing revealed a strong expression of miR‐24–3p in primary B cells, plasma blasts, plasma cells, and in plasmacytoma cells. In vitro studies using primary cells and the plasmacytoma cell line RPMI‐8226 revealed that (i) expression of miR‐24–3p mediates plasma cell survival, (ii) miR‐24–3p is upregulated by IL‐6 and SDF‐1α, (iii) IL‐6 mediates cell survival under ER stress conditions via miR‐24–3p expression, and (iv) IL‐6‐induced miR‐24–3p expression depends on the activity of the MAP kinase Erk1/2. These results suggest a direct connection between an external survival signal and an intracellular microRNA in regulating plasma cell survival. miR‐24–3p could therefore be a promising target for new therapeutic strategies for autoimmune and allergic diseases and for multiple myeloma.     

Degenerate mode band-pass birdcage coil for accelerated parallel excitation.

An eight-rung, 3T degenerate birdcage coil (DBC) was constructed and evaluated for accelerated parallel excitation of the head with eight independent excitation channels. Two mode configurations were tested. In the first, each of the eight loops formed by the birdcage was individually excited, producing an excitation pattern similar to a loop coil array. In the second configuration a Butler matrix transformed this "loop coil" basis set into a basis set representing the orthogonal modes of the birdcage coil. In this case the rung currents vary sinusoidally around the coil and only four of the eight modes have significant excitation capability (the other four produce anticircularly polarized (ACP) fields). The lowest useful mode produces the familiar uniform B(1) field pattern, and the higher-order modes produce center magnitude nulls and azimuthal phase variations. The measured magnitude and phase excitation profiles of the individual modes were used to generate one-, four-, six-, and eightfold-accelerated spatially tailored RF excitations with 2D and 3D k-space excitation trajectories. Transmit accelerations of up to six-fold were possible with acceptable levels of spatial artifact. The orthogonal basis set provided by the Butler matrix was found to be advantageous when an orthogonal subset of these modes was used to mitigate B(1) transmit inhomogeneities using parallel excitation.     

Myelinated and nonmyelinated nerves: comparison of proton MR properties

The magnetic resonance (MR) relaxation rates of protons were compared in the myelinated and nonmyelinated nerves of the garfish. The long, large olfactory nerve of the garfish, as an easily accessible source of nonmyelinated axons, is uniquely suited for such a comparison. The T1 and T2 measurements revealed distinct and consistent differences between nonmyelinated olfactory nerves and myelinated optic and oculomotor nerves. Comparisons between water content, lipid content, and relaxation rates indicated that the differences in MR properties represent complex differences in the distribution and physical environment of the constituent lipid and water protons.     

Segmental intestinal muscular thinning: a possible cause of intestinal obstruction in the newborn

Intestinal obstruction proximal to a transition zone without an interposed physical barrier usually indicates Hirschsprung disease. The authors report one case of focal small bowel muscular thinning just distal to a transition zone that produced clinical and radiographic findings that simulated long-segment Hirschsprung disease in a 2-day-old infant.