Hepatitis C Virus Epitope Immunodominance and B Cell Repertoire Diversity

Despite the advent of effective, curative treatments for hepatitis C virus (HCV), a preventative vaccine remains essential for the global elimination of HCV. It is now clear that the induction of broadly neutralising antibodies (bNAbs) is essential for the rational design of such a vaccine. This review details the current understanding of epitopes on the HCV envelope, characterising the potency, breadth and immunodominance of antibodies induced against these epitopes, as well as describing the interactions between B-cell receptors and HCV infection, with a particular focus on bNAb heavy and light chain variable gene usage. Additionally, we consider the importance of a public repertoire for antibodies against HCV, compiling current knowledge and suggesting that further research in this area may be critical to the rational design of an effective HCV vaccine.     

S100A8 induction in keratinocytes by ultraviolet A irradiation is dependent on reactive oxygen intermediates

Cutaneous exposure to ultraviolet (UV) A (320-400 nm) results in the formation of damaging reactive oxygen intermediates, which are implicated as mediators of DNA damage, apoptosis, and photoaging. S100A8 is a low-molecular-weight calcium-binding protein, highly sensitive to oxidation. In this study, UVA-induced S100A8 expression by keratinocytes was investigated. UVA (50-100 kJ per m2) strongly induced S100A8 in differentiated keratinocytes in the epidermis of BALB/c mice. Similarly, S100A8 mRNA and monomeric protein were significantly upregulated in PAM212 cells (a murine keratinocyte cell line) in response to 10 kJ per m2 UVA 24 h after irradiation. Although S100A9 associates with S100A8 in neutrophils and abnormally differentiated keratinocytes (human psoriasis), in this study it was not coinduced with keratinocyte S100A8. Dorsal application of 4-hydroxy-tempo (a superoxide dismutase-mimicking agent) to mice concentration-dependently reduced UVA-induced S100A8 expression. Incubation of PAM212 cells with superoxide dismutase and catalase during UVA irradiation also abrogated S100A8 induction. These results suggest that UVA-induced S100A8 is expressed by keratinocytes in response to generation of reactive oxygen intermediates.     

Clinical profile of acute renal failure in children admitted to the department of pediatrics, Tikur Anbessa Hospital

Case records of 30 pediatric patients with the diagnosis of acute renal failure (ARF) admitted to Tikur Anbessa Hospital in Addis Ababa between October 1997 and October 2001 were analyzed There were 15 females and 15 males. Three patients had glomerulonephritis, in two patients the cause of acute renal failure was not known, one child had obstructive uropathy. Twenty-three patients had post-diarrheal hemolytic uremic syndrome. The age ranges of post-diarrheal hemolytic uremic syndrome cases were between 0.6 years and 7 years with a median age of 2.2 years. Fourteen patients died of acute renal failure among this hemolytic urmic syndrome contributed to the death of 9 patients. The commonest clinical presentation was severe oligo-anuria in (25 patients), edema in (22 patients), and bloody diarrhea in (21 patients). From stool cultures of 16 patients with hemolytic uremic syndrome, there were five isolates of Shigella species, two isolates of E. coli, and two isolates of Salmonella species. Five patients had non-oliguric acute renal failure. Hemolytic uremic syndrome is the leading cause of acute renal failure in infants and young children in our series. Vigorous resuscitation and early dialysis will reduce mortality rate.     

Chylothorax and Chylopericardial Tamponade in a Hemodialysis Patient with Catheter-Induced Superior Vena Cava Stenosis

Chylothorax and chylopericardium refer to the presence of milky, triglyceride-rich chylous fluid in the thoracic and pericardial spaces, respectively. Both conditions are extremely uncommon in end-stage renal disease patients on dialysis. We report the first known case of combined chylothorax and chylous pericardial tamponade in a dialysis patient associated with catheter-induced superior vena cava (SVC) stenosis. A successful outcome was achieved with drainage of both chylous effusions in combination with angioplasty of the SVC stenosis.     

Chemokine expression and leucocyte infiltration in Sjogren's syndrome

OBJECTIVE: To investigate the expression and source of chemokines in minor salivary gland biopsies (MSGs) in patients with Sjogren's syndrome (SS). METHODS: Immunohistochemical analysis was used to determine the pattern of chemokine expression in MSGs from patients with (n=6) and without (n=5) SS, as well as to examine the phenotype of both resident and infiltrating cells expressing chemokines. RESULTS: Significant differences in the number of infiltrating mononuclear (MN) cells in patients with and without SS were noted. Ductal epithelial cells of SS biopsies expressed significantly increased levels of macrophage inflammatory protein (MIP)-1alpha, MIP-1beta, interleukin-8 (IL-8) and RANTES (Regulated upon Activation, Normal T cell Expressed and Secreted). Biopsies from patients with SS showed that MIP-1beta was expressed by 51% of infiltrating cells, while 41% expressed MIP-1alpha, whereas 22 and 7% expressed RANTES and IL-8, respectively. CONCLUSION: Chemokines expressed by ductal epithelial cells may attract circulating leucocytes, in particular CD4+ T cells, towards the site of inflammation, thereby orchestrating the influx of MN cells characteristically seen in MSGs in SS. Chemokines may be induced directly by a putative triggering agent for SS, or secondary to the release of pro-inflammatory cytokines produced by epithelial cells. These findings further implicate epithelial cells as playing a major role in the pathogenesis of SS and implicate chemokines in the leucocyte recruitment in this setting.      

Differential expression of leukocyte immunoglobulin-like receptors on cord-blood-derived human mast cell progenitors and mature mast cells

The leukocyte Ig-like receptors (LILRs) comprise a family of cell-surface immunoregulatory receptors with activating and inhibitory members. The inhibitory LILRs possess cytoplasmic ITIMs that down-regulate signaling by nonreceptor tyrosine kinase cascades. The activating members have a truncated cytoplasmic domain and signal through the FcR gamma chain. We examined the expression of LILRs on human mast cells during their development in vitro. Progenitor mast cells expressed cell surface inhibitory LILRB1, -B2, -B3, and -B4 and activating LILRA1. However, although mature cord blood-derived mast cells (hMCs) had detectable mRNA encoding multiple LILRs, none were expressed on the cell surface. Culture of progenitor mast cells or hMCs with various cytokine combinations failed to retain or induce cell surface expression of the LILRs. It is interesting that hMCs expressed LILRB5 in cytoplasmic granules and upon cross-linking of the high-affinity IgE receptor, released LILRB5 into the culture medium. Our results demonstrate that LILRs are developmentally regulated in human mast cells and that LILRB5 is expressed in mast cell granules and the release of soluble LILRB5 following IgE FcR-dependent stimulation, which has potential for amplification of mast cell-dependent, inflammatory responses.     

Association of Physical Function and Survival in Older-Adult Renal Transplant Recipients

There is an increase in older-adult renal transplant recipients in United States. The objective of this study was to assess the association between physical function (PF) and patient survival in renal transplant recipients who are aged 65 years or older. Using United Network for Organ Sharing (UNOS) data from 2007 to 2016, renal transplant recipients aged 65 years or older were included. Multivariable Cox regression was used to assess associations between survival and functional status adjusted for age, sex, race, donor quality, diabetes, and dialysis vintage. The study identified 26,721 patients. Patient survival was significantly higher in recipients who needed no assistance and lowest in patients in need of total assistance (P < .0001). In deceased donor (DD) transplants, the relative risk for mortality was 2.06 (1.74-2.43) for total assistance and 1.17 (1.08-1.28) for moderate assistance compared to no assistance (P < .0001). In living donor (LD) transplants, the relative risk of mortality was 1.38 (0.78-2.42) for patients needing total assistance and 1.37 (1.14-1.65) for patients needing moderate assistance compared to patients who did not need assistance (0.003). PF is an independent predictor of post-transplant mortality. Assessment of older potential renal transplant recipients should include assessment and standardization of functional status to counsel about post-transplant survival.     

The co-expression of activating and inhibitory leukocyte immunoglobulin-like receptors in rheumatoid synovium

Rheumatoid arthritis (RA) is a chronic inflammatory synovitis, with destruction of juxtaarticular cartilage and bone, likely mediated by lipid mediators, cytokines, and proteases released from inflammatory leukocytes. The mechanisms regulating leukocyte activation in rheumatoid synovium are not fully elucidated. A new family of cell surface proteins termed leukocyte immunoglobulin-like receptors (LIRs) has been shown in vitro to modulate cellular responses through immunoreceptor tyrosine-based inhibitory motifs or through association with the Fc receptor gamma chain that contains immunoreceptor tyrosine-based activation motifs. We studied the expression of inhibitory and activating LIRs in the synovium of six RA patients, three osteoarthritis patients, and three controls by immunohistochemistry. The synovium from patients with early RA showed extensive expression of the inhibitory LIR-2 and the activating LIR-7 on macrophages and neutrophils. Some mast cells and endothelial cells expressed LIR-7. There was limited expression of LIRs in synovium from two patients with long-standing RA, patients with osteoarthritis, and controls. LIR-2 recognizes MHC class I molecules. We therefore suggest that LIRs may regulate the activation of infiltrating leukocytes in synovial tissue and are a potential therapeutic target.