In vitro activation of natural killer-like cytotoxicity by specifically in vivo primed T-helper lymphocytes in the rat.

The interaction between the rat non-cytotoxic T lymphocyte subset, which is marked by the W3/25 monoclonal antibody, and natural killer cells was investigated. Specifically in vivo primed lymph node cells were restimulated in vitro with the priming antigen and co-cultured with a source of natural killer cells and their precursors. Cytotoxic activity, generated during a 4 day incubation period, was assessed by lysis of a rat natural killer cell-sensitive tumour target cell line, y3Ag123. This cytotoxic activity was more fully described as natural killer cell cytotoxicity on the basis of target cell specificity, using a range of natural killer cell-susceptible and -resistant targets. The W3/25-positive T cell, separated from the in vivo primed lymph node cells by nylon wool column elution, antibody labelling and sorting on the fluorescence-activated cell sorter, was shown to be necessary to stimulate the generation of this activity. W3/25-negative cells were not active in this respect. The activation was shown to be mediated via lymphokine(s), probably interleukin-2, present in concanavalin A-induced lymphocyte culture supernatants. These supernatants could be used to substitute for in vivo primed, restimulated W3/25-positive lymph node cells in activating natural killer cell cytotoxicity from normal spleen cells. Nylon wool column-eluted spleen cells, activated in vitro with conditioned medium were separated into OX8-positive and OX8-negative subsets using the fluorescence-activated cell sorter. The distribution of cytotoxic activity related to that of freshly derived rat natural killer cells.     

Outer membrane proteins of Brucella abortus: isolation and characterization.

Outer membrane proteins were derived from one rough and four smooth strains of Brucella abortus by sequential extraction of physically disrupted cells with N-lauroylsarcosinate and dipolar ionic detergent. Extraction of outer membrane proteins was ineffective, however, without predigestion with lysozyme. Three groups of proteins were present and could be separated in their native state by sequential anion-exchange chromatography and gel filtration. Membrane proteins contained substantial quantities of tightly adherent lipopolysaccharide which could be reduced but not eliminated by extraction of cells with trichloroacetic acid before disruption. Group 2 proteins, apparently trimers in their native state, gave rise to 43,000- and 41,000-molecular-weight bands after complete denaturation in sodium dodecyl sulfate. They were antigenically identical among all the strains, showed close resemblance in amino acid composition to each other and a general similarity to OmpF of Escherichia coli, and are proposed to be the porins of B. abortus. Group 3 proteins occurred as 30,000-molecular-weight bands on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, although additional bands were frequently observed in this region. In none of the strains did group 3 proteins manifest heat-modifiable characteristics. Proteins of different strains bore a high degree of similarity to each other in amino acid composition, except in methionine, isoleucine, tyrosine, and histidine. Differences occurred consistently in amino acid composition between group 2 and 3 proteins, and some of these correspond to differences between OmpF and OmpA. Group 2 and 3 proteins were antigenically distinct from each other, but the principal group 3 antigens were shared among all the strains. Despite the lack of heat modifiability, perhaps influenced by adherent lipopolysaccharide, group 3 proteins are proposed as counterparts to OmpA. Most of the group 1 proteins, minor components, were physically associated with those of group 3 unless in sodium dodecyl sulfate. Group 1 proteins produced a major band at 94,000 and exhibited heat modifiability. No evidence was found of a low-molecular-weight lipoprotein in the outer membrane of B. abortus, but this is not taken to exclude its occurrence.     

Nature of the genetic determinant controlling encapsulation in Staphylococcus aureus Smith.

Two strains of Staphylococcus aureus, Smith and M, were studied for the elimination of encapsulation. For S. aureus M, encapsulation was stable. For S. aureus Smith, spontaneous loss of encapsulation was 1.3% and increased markedly in medium containing surface-active agents. In the presence of sodium dodecyl sulfate, unencapsulated cells had a considerable selective advantage. Attempts to demonstrate covalently closed circular plasmid deoxyribonucleic acid were unsuccessful. In cultures of unencapsulated cells, encapsulated cells were observed occasionally. These data argue against a plasmid location for the determinants controlling encapsulation in this organism in spite of a high spontaneous loss of this character.     

A randomised controlled trial to test the feasibility of a collaborative care model for the management of depression in older people

BACKGROUND: Depression is the most common mental health disorder in people aged over 65 years. Late-life depression is associated with chronic illness and disability. AIM: To investigate the feasibility of a collaborative care model for depression in older people in a primary care setting. DESIGN OF STUDY: Randomised controlled trial with 16-weeks follow up. SETTING: A primary care trust in Manchester. METHOD: Participants were 105 people aged 60 years or older who scored 5 or more on the Geriatric Depression Scale; 53 were randomly allocated to an intervention group and 52 to a usual care group. The intervention group received care managed by a community psychiatric nurse who delivered an intervention comprising a facilitated self-help programme with close liaison with primary care professionals and old-age psychiatry according to a defined protocol. The usual care group received usual GP care. A nested qualitative study explored the views of the health professionals and patients regarding the acceptability and effectiveness of the intervention. RESULTS: The main outcome measure was recovery from depression. Patients in the intervention group were less likely to suffer from major depressive disorder at follow up compared with usual care (0.32, 95% confidence = interval = 0.11 to 0.93, P = 0.036). The qualitative component of the study demonstrated the acceptability of the intervention to patients. CONCLUSION: A model of collaborative care for older people with depression, used in a primary care setting with a facilitated self-help intervention is more effective than usual GP care. This study demonstrates that the implementation of a collaborative care model is feasible in UK primary care and that the intervention is effective and acceptable to patients.