The role of TLR2 in nerve injury-induced neuropathic pain is essentially mediated through macrophages in peripheral inflammatory response

Activation of macrophages/microglia via toll-like receptors (TLRs) plays an important role in inflammation and host defense against pathogens. Pathogen-associated molecular patterns bind TLRs, thereby triggering NF-κB signaling and production of proinflammatory cytokines. Recent data suggest that nonpathogenic molecules resulting from trauma can also trigger inflammation via TLRs. We sought to determine whether peripheral nerve injury could induce the expression of TLR2 on the site of injury-damaged nerves and/or in the central nervous system and to investigate whether TLR2 is necessary for the development of nerve injury-induced neuropathic pain. We observed a significant increase in TLR2, IκB-α, and TNF-α mRNAs in damaged nerves. Increased inflammation-related molecules were found essentially on ED1(+) macrophages. Expression of both IκB-α and TNF-α in peripheral injured nerves was reduced in TLR2 deficient mice where the recruitment of ED1(+) cells is significantly impaired. Although after peripheral nerve injury, spinal microglia became highly activated showing an increase in Iba-1 immunoreactivity and an enlargement of their cell bodies, neither TLR2 mRNA nor IκB-α mRNA was detected in activated microglia. Nerve injury-evoked spinal microglial activation was not significantly altered in TLR2 KO mice. Paw withdrawal threshold and latency in response to mechanical and heat stimuli, respectively, decreased shortly after nerve lesion in wild type mice. In TLR2 KO mice, nerve injury-induced thermal hyperalgesia was completely abolished contrary to that seen in wild-type mice, whereas mechanical allodynia was partially reduced. We suggest that TLR2 is necessary for the development of neuropathic pain and its contribution is more important in thermal hypersensitivity than that of mechanical allodynia.     

Pregnancy and lupus nephritis: report of 20 cases

AimPregnancies in women with lupus nephritis (LN) are a high-risk situation. The aim of this study is to evaluate the impact of pregnancy on LN on either maternal and fetal prognosis.Patients and methodsIt is a retrospective study of 20 pregnancies in 12 women with lupus nephritis.ResultsThere were 19 live births and five fetal losses. LN flares were observed in 50 % of the cases during pregnancy and 25 % after delivery.ConclusionPregnancies in women with LN require a multidisciplinary monitoring and intense maternal and fetal care.     

Infectious Diseases in Sub-Saharan Immigrants to Spain

Immigrants may be carriers of infectious diseases because of the prevalence of these diseases in their country of origin, exposure during migration, or conditions during resettlement, with this prevalence being particularly high in sub-Saharan Africans. We performed a retrospective review of 180 sub-Saharan immigrants screened for infectious diseases at an International Health Center from January 2009 to December 2012. At least one pathogenic infectious disease was diagnosed in 72.8% patients: 60.6% latent tuberculosis infection, 36.8% intestinal parasites (intestinal protozoa or helminths), 28.1% helminths, 14.8% hepatitis B surface antigen positive, 1.2% anti-hepatitis C virus positive, 1.2% human immunodeficiency virus–positive, and 1.2% malaria. Coinfections were present in 28.4%. There was significant association between eosinophilia (absolute count or percentage) or hyper-IgE and the presence of helminths (P < 0.001). Relative eosinophilia and hyper-IgE were better indicators of helminth infection than absolute eosinophilia, particularly for schistosomiasis and strongyloidiasis. We found a high prevalence of infectious diseases in sub-Saharan immigrants, which could lead to severe health problems (in the absence of prompt treatment), representing a high cost to the public health system and possible transmission in the host country. Accurate screening and tailored protocols for infectious diseases are recommended in sub-Saharan immigrants.     

Novel mutations in ALOX12B in patients with autosomal recessive congenital ichthyosis and evidence for genetic heterogeneity on chromosome 17p13

We report clinical and molecular findings in 20 patients from 11 families with autosomal recessive congenital ichthyosis (ARCI) linked to chromosome 17p13, and attributed to mutations in the ALOX gene cluster, which includes three lipoxygenase genes, ALOXE3, ALOX12B, and ALOX15B. We identified six novel missense mutations and one novel deletion leading to a premature stop codon in ALOX12B in only six out of the 11 families which led us to investigate a possible implication of ALOX15B. Mutation analysis of this gene, as well as ALOXE3, which is known to be mutated in some cases of ARCI, failed to reveal causative mutations in the five remaining ARCI families, indicating that other genes on chromosome 17p13 may be involved in this disease. However, by adding new variants to the repertoire of ALOX12B mutations in non-bullous congenital ichthyosiform erythroderma, our data contribute to an enlargement of the spectrum of mutations for the development of efficient molecular genetic tests for analysis of at risk individuals whose carrier status is unknown.     

The EPIYA-ABCC motif of Helicobacter pylori cagA gene and gastric carcinogenesis in Casablanca population

BackgroundH. pylori infection induce atrophic gastritis (AG) and intestinal metaplasia (IM) that can lead to gastric cancer (GC). The severity of gastric lesions is related to H. pylori genetic diversity. The oncogenic potential of H. pylori cagA virulence factor is linked to its high polymorphic EPIYA motifs.ObjectivesOur aim was to evaluate the association of EPIYA motifs with the risk of AG and IM in Casablanca population.MethodsA total of 210 patients suffering from gastric lesions (chronic gastritis, AG, and IM) was enrolled. H. pylori infection and the type of lesions were diagnosed by ureC PCR and histological examination, respectively. Detection of the cagA gene, and the type of EPIYA motifs, were carried out by PCRResultsThe prevalence of H. pylori and cagA gene was 95% and 37%, respectively. CagA-positive strains were associated with the risk of IM. The EPIYA motifs detected were: EPIYA-ABC (58%), EPIYA-ABCC (22%), and EPIYA-AB (20%). The EPIYA-ABCC motif was associated with the risk of IM (p-value = 0.007), compared to AG (p-value = 0.28).ConclusionThe EPIYA-ABCC motif might be a useful marker for the identification of patients at high risk of developing IM that can lead to GC.     

Early and late hospital mortality in myocardial infarction. Causes and prognostic factors. Apropos of 140 cases

The purpose of this work is to study the causes of early and late in-hospital mortality of myocardial infarction, to define elements of prognosis and to attempt to prevent the fatal outcome of the coronary disease. This study concerns 107 men and 33 women, between the ages of 30 and 83 years (mean age 62.8 years). The total mortality is 12% (early: 6.5%, late: 5.5%. 66% of the patients are over 60 and 45% present 3 or more coronary risks factors. The clinical picture is characterized by frequent initial complications (84% of the cases), dominated by hemodynamic failure. The infarction is most of the time located anteriorly (56.6% of the cases). Primary cardiogenic shock represents the main cause of early mortality (55.3%). A recurrent infarction represents 75% of the causes of late deaths. Tri-vessels involvement and alteration of the ventricular function are noted in 9 out of 14 coronary arteriograms. Prognosis factors are proposed to differentiate high risk patients requiring an early coronary arteriogram in view of a specific medical and/or surgical treatment. The best signs of a poor prognosis are: tri-vessels involvement and alteration of the ventricular function.     

The Catalonian Expert Patient Programme for Chagas Disease: An Approach to Comprehensive Care Involving Affected Individuals

The Catalonian Expert Patient Programme on Chagas disease is a initiative, which is part of the Chronic Disease Programme. It aims to boost responsibility of patients for their own health and to promote self-care. The programme is based on nine sessions conducted by an expert patient. Evaluation was focusing in: habits and lifestyle/self-care, knowledge of disease, perception of health, self-esteem, participant satisfaction, and compliance with medical follow-up visits. Eighteen participants initiated the programme and 15 completed it. The participants were Bolivians. The 66.7 % of them had been diagnosed with chagas disease in Spain. The 100 % mentioned that they would participate in this activity again and would recommend it to family and friends. The knowledge about disease improve after sessions. The method used in the programme could serve as a key strategy in the field of comprehensive care for individuals with this disease.