Limited long-term naive CD4+ T cell reconstitution in patients experiencing viral load rebounds during HAART

Long-term (3.5 years) immune reconstitution in relation to viral load response was determined. Plasma HIV-1 RNA was suppressed in 40 patients (full responders) up to 42 months, and 17 patients achieved partial response. The measurements of CD4⁺ and CD8⁺ T lymphocyte subsets (CD45RA, CD45RACD62L, CD45RO, CD28, CD38) were carried out by flow cytometry. Full responders had a significant increase of CD4⁺ and all CD4⁺ T subsets both up to 6 and from 6 to 42 months, while the increase for partial responders was only up to 6 months. By 6 months, higher slopes were observed in full versus partial responders in the % of CD28 on CD4⁺ and the % of CD4⁺ memory subset and in both naïve and memory CD4⁺ subsets from 6 to 42 months. The percentage of CD8⁺ and its subsets was decreased significantly in full responders both up to 6 and from 6 to 42 months (except for an increase in the CD8⁺CD45RA⁺ CD62L⁺ cells), while in partial responders this decrease was only up to 6 months. Lower slopes were observed in full versus partial responders from 6 to 42 months in the percentages of CD8⁺, CD8⁺CD45RO⁺, CD8⁺CD28⁻, and CD8⁺CD38⁺ T cells. In conclusion, full responders have a stronger long-term naive CD4⁺ T cell subset reconstitution than partial responders. J. Med. Virol. 73:235–243, 2004. © 2004 Wiley-Liss, Inc.     

A prospective study on lung toxicity in patients treated with gemcitabine and carboplatin: clinical, radiological and functional assessment.

BACKGROUND: Small series and retrospective studies have suggested that treatment with gemcitabine may be associated with pulmonary toxicity. However, a prospective evaluation of cancer patients treated with gemcitabine-based chemotherapy without neoplastic involvement of the thorax and without administration of radiotherapy has not been performed. PATIENTS AND METHODS: To investigate this issue, 41 consecutive patients receiving gemcitabine and carboplatin underwent prospective evaluation of lung function, which included pulmonary symptoms, pulmonary function tests, arterial blood gases and radiographic studies. Assessment was performed before and after completion of chemotherapy in all patients. Patients with a substantial decline in diffusion capacity for carbon monoxide (DLCO), defined as a drop of > or = 20%, were reassessed 2 months later. RESULTS: After chemotherapy, there were no significant changes in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, alveolar volume or total lung capacity. In contrast, there was a significant decline in DLCO (73 +/- 22 versus 67 +/- 24% predicted; P = 0.017) and in carbon monoxide transfer coefficient (KCO) (89 +/- 24 versus 80 +/- 24% predicted; P = 0.004). Arterial blood gases did not change following treatment. Ten of the 41 patients (24%) exhibited a substantial decline in DLCO, which, however, recovered within 2 months (DLCO at baseline, immediately after therapy and at 2 months after completion of treatment, 84 +/- 14, 58 +/- 16 and 77 +/- 17% predicted, respectively; P < 0.001; baseline DLCO versus DLCO at 2 months, P > 0.05). Four of the 41 patients (10%) experienced dyspnea, which was self-limiting, with the exception of one patient who developed interstitial lung fibrosis. Among the various risk factors examined, older age, female gender and lower baseline DLCO were associated with more profound changes in DLCO post-treatment. CONCLUSIONS: This prospective analysis showed that the combination of gemcitabine and carboplatin induces a significant, but reversible, decrease in diffusion capacity, which is mostly asymptomatic. Thus, this regimen is safe as regards clinically significant lung toxicity.     

Plants used for the treatment of diabetes in Israel

In an extensive ethnobotanical survey (130 informants) of the medicinal plants of Israel, 16 species were found to be used for hypoglycaemic treatments. The list includes Achillea fragrantissima (Forssk.) Sch.-Bip, Ammi visnaga (L.) Lam, Atriplex halimus L., Capparis spinosa L., Ceratonia siliqua L., Cleome droserifolia (Forssk.) Del., Eryngium creticum Lam., Inula viscosa (L.) Ait., Matricaria aurea (Loefl.) Sch.-Bip, Origanum syriaca L., Paronychia argentea Lam, Prosopis farcta (Banks et Sol.) Macbride, Salvia fruticosa Mill., Sarcopoterium spinosum (L.) Sp., and Teucrium polium L.; eight of them (marked with an asterisk) are first recorded here as used for this purpose.     

A preliminary classification of the healing potential of medicinal plants, based on a rational analysis of an ethnopharmacological field survey among Bedouins in the Negev desert, Israel

In the course of an ethnopharmacological survey carried out among the Bedouins of the Negev desert, it was noticed that in addition to the use of modern medical services, medicinal plants were also being employed. We deemed it worthwhile, therefore, to investigate the current status of herbal medicine among the Negev Bedouins and to evaluate the relative efficiency of the plants used. To evaluate plant effectiveness by enquiries among patients once treated was found to be difficult and impractical. Hence, each interviewed informant was first requested to volunteer information on the plants and their uses. Next, to avoid the risk of memory failure, a list of 50 commonly used species was read out and the informant was asked to provide information on any that were familiar to him as medicinal herbs. Of 81 plant species mentioned by our 27 informants, 41 were named or recognized by more than 3. These species were arranged in accordance with the percentage of informants suggesting the same medicinal use for a given species as compared with the total number of informants reporting any sort of use for that plant. The obtained ratio was defined as the fidelity level (FL). The rank-order priority (ROP) of the plants was derived from these FL values. The relative popularity level (RPL) of the plants encountered was determined and plants were accordingly designated as "popular" or "unpopular". FL values were further adjusted, according to RPL value. We found that the bark of Phagnalon rupestre is widely used to induce deliberate burns for the healing of various ailments (ROP = 100), while infusion of the shoots of Teucrium polium, or of Artemisia herba-alba is employed to a lesser degree (ROP = 66 and 56, respectively) to relieve stomach disorders. Because the latter two species show fairly high ROP and are seen to be directly curative, they merit further investigation. Additional findings and implications of our ethnopharmacological survey are duly discussed.     

Salivary alkaline phosphatase activity and chronological age as indicators for skeletal maturity

Objectives:To investigate the relationship between salivary alkaline phosphatase activity (ALP), protein concentration, and chronological age with cervical vertebral maturation stages (CVMS) as noninvasive biomarkers for skeletal maturity assessment.Materials and Methods:This cross-sectional study included 79 subjects (48 females, 31 males; 7 to 23 years old) categorized into five CVMS based on lateral cephalographs evaluated by three examiners. ALP activity and protein concentration in unstimulated whole saliva were compared among five CVMS. The association between age and CVMS was assessed and five multinomial logistic regression models were utilized to predict CVMS based on salivary ALP activity, protein concentration, and chronological age.Results:Salivary ALP reached the peak at early pubertal stage and then declined with a significant difference between CVMS I and CVMS II (P < .001) and between CVMS I and CVMS V (P = .004). A significant positive correlation between age and CVMS was found (r_s = 0.763, P < .001). The models'' overall correct classification rates for predicting CVMS were 32.9% using protein concentration, 35.4% using ALP activity, and 53.2% using both ALP activity and age.Conclusions:The combination of salivary ALP activity and chronological age may provide the best CVMS prediction.