Stronger hepatitis C virus-specific CD8+ T-cell responses in HIV coinfection

Hepatitis C virus (HCV) is a widespread chronic infection that shares routes of transmission with human immunodeficiency virus (HIV). Thus, coinfection with these viruses is a relatively common and growing problem. In general, liver disease develops over years with HIV coinfection, when compared to decades in HCV monoinfection. The role of the immune system in the accelerated pathogenesis of liver disease in HIV/HCV coinfection is not clear. In this study, we compared the frequency, magnitude, breadth and specificity of peripheral blood CD4+ and CD8+ T-cell responses between HCV-monoinfected and HCV/HIV-coinfected individuals and between HIV/HCV-coinfected subgroups distinguished by anti-HCV antibody and HCV RNA status. While HIV coinfection tended to reduce the frequency and breadth of anti-HCV CD8+ T-cell responses in general, responses that were present were substantially stronger than in monoinfection. In all groups, HCV-specific CD4+ T-cell responses were rare and weak, independent of either nadir or concurrent CD4+ T-cell counts of HIV-infected individuals. Subgroup analysis demonstrated restricted breadth of CD8+ HCV-specific T-cell responses and lower B-cell counts in HIV/HCV-coinfected individuals without anti-HCV antibodies. The greatest difference between HIV/HCV-coinfected and HCV-monoinfected groups was substantially stronger HCV-specific CD8+ T-cell responses in the HIV-coinfected group, which may relate to accelerated liver disease in this setting.

Novel mechanical properties in lamellar phases of liquid-crystalline diblock copolymers

Structural properties of flexible nematic diblock copolymers in the lamellar phase are investigated using a mean-field model. We address two complementary questions on the mechanics of the system: 1) How does the nematic order affect the elasticity of the one-dimensional solid? 2) What effect does the block copolymer microstructure has on the orientation of the nematic director? In the limit when the microstructure does not influence the nematic director orientation we predict a soft lamellar compression mode. When the microstructure does influence the nematic director orientation, small compressions lead to conventional elasticity, until a critical strain is reached, where there is then a transition to a softer response. On the other hand, we show that an identifiable lamellar symmetry provides a direction along which the nematic director prefers to align. Our model provides avenues to explore nonlinear properties of flexible diblock copolymers in which the monomers on both sides have mesogenic side groups.

Evaluation of novel particles as an inhalation system for GLP-1

AIM

The feasibility of administering native glucagon-like peptide 1 (GLP-1) as GLP-1 Technosphere Inhalation Powder for diabetes therapy has been demonstrated in a rat model.

METHODS

GLP-1 Technosphere Inhalation Powders containing 5, 10 and 15% GLP-1 were prepared and administered to healthy female Sprague-Dawley rats and to male Zucker diabetic obese rats. Rats received a single dose of GLP-1 Technosphere Powder by pulmonary insufflation. GLP-1 pharmacokinetic and pharmacodynamic responses were measured.

RESULTS

Maximum circulating GLP-1 concentrations were achieved at approximately 10 min after dosing with detectable levels at 40 min. In a food consumption study, Sprague-Dawley rats receiving GLP-1 Technosphere Powder once-daily consumed less food than control rats for up to 24 h after dosing. Cumulative food consumption was decreased approximately 10% after 78 h. In an intraperitoneal glucose tolerance test, Zucker diabetic fatty rats receiving 2 mg GLP-1 Technosphere Powder (0.3 mg GLP-1) by pulmonary insufflation exhibited lower glucose concentrations and higher insulin concentrations than control rats. Pancreatic evaluations showed no differences in apoptotic index or cell proliferation of beta-cells. In addition, a dose-related increase in insulin expression within the pancreas was observed.

CONCLUSIONS

These data demonstrate the feasibility of administering native GLP-1 as GLP-1 Technosphere Inhalation Powder for diabetes therapy.

Effects of growth factors on corneal wound healing

Healing of ocular surface wounds is a complex process involving migration, mitosis, and differentiation of epithelial and stromal cells. Endogenously produced peptide growth factors such as epidermal growth factor (EGF), transforming growth factor alpha (TGF-alpha), or transforming growth factor beta (TGF-beta) may play key roles in the natural wound healing process. Lacrimal gland cells were reported to synthesize and secrete EGF into tear fluid where it may enhance healing of corneal epithelial and stromal injuries by an exocrine pathway. EGF stimulated DNA synthesis of epithelial cells and stromal fibroblasts in culture, stimulated synthesis of fibronectin by epithelial cells and was chemotactic for human epithelial and stromal cells. Human corneal epithelial cells also synthesized TGF-alpha which may influence epithelial cells by an autocrine pathway. TGF-beta, which is a potent inducer of lysyl oxidase mRNA levels in cultures of human scleral fibroblasts, may be the factor most responsible for inducing synthesis of corneal extracellular matrix components after an injury. Treatment of epithelial injuries ocular surface wounds with exogenous peptide growth factors also accelerated healing in rabbits and primates. Treatment of severe ocular surface injuries caused by alkali with a combination of EGF, fibronectin, a synthetic collagenase inhibitor, and Aprotinin significantly blocked ulceration and enhanced epithelial regeneration. Clinical trials of topical treatment of EGF for ocular surface wounds suggest that peptide growth factors may be a valuable adjuvant for treatment of ocular surface wounds.

Gender and quality of life for colorectal cancer survivors with an ostomy

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Background: Intestinal stomas can pose significant challenges for colorectal cancer (CRC) survivors. Specifying common challenges and sub-group differences will further the development of tailored interventions to improve health-related quality of life (HRQOL) for survivors with an ostomy. Methods: This matched cross-sectional study collected survey and medical records data from CRC survivors in three regions of Kaiser Permanente (Northern California, Northwest, and Hawaii). The survey instrument included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and SF-36v2 questionnaires. Eligible colorectal cancer patients were at least five years beyond diagnosis. Two groups of CRC survivors were surveyed: those with a permanent ostomy (cases) and those that did not require an ostomy (controls). Survivors were matched on tumor site (rectum vs. colon), gender, age, and time since diagnosis. To identify differences in HRQOL associated with having an ostomy, outcomes were compared between the two groups using regression analysis with adjustment for tumor site (rectum vs. colon), age, comorbidity score, income, and work status. Results: Our response rate was 52 percent (675/1304). Cases and controls had similar demographic characteristics. Men and women showed significant differences in the relationship between ostomy and HRQOL and are reported separately. Based on the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared to controls, while only female cases showed significantly worse overall HRQOL and psychological well-being. Based on the SF-36v2, statistically significant and clinically meaningful differences between female cases and controls were observed for scores on seven of the eight scales and on the standardized summary scores. For men, mental health was statistically significantly lower for cases than for controls, but the difference did not reach a meaningful level. Conclusions: CRC survivors with an ostomy experience multiple HRQOL challenges compared to persons who never had an ostomy, even five years beyond the diagnosis. Men and women report a different profile of challenges, suggesting the need for targeted or gender-specific interventions to improve HRQOL in this population.

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The NERC DataGrid services

This short paper outlines the key components of the NERC DataGrid: a discovery service, a vocabulary service and a software stack deployed both centrally to provide a data discovery portal, and at data providers to provide local portals and data and metadata services.

Synthesis and biologic activity of conformationally constrained analogs of L-363,301

We report the synthesis, biological activity and conformational analysis of analogs of the cyclic hexapeptide L-363,301, c[Pro6-Phe7-D-Trp8-Lys9-Thr10-Phe11] (numbering as in the native hormone somatostatin-14). The d-Trp in position 8 was replaced with (2R,3S)- and (2R,3R)-beta-MeTrp respectively, with an added methyl group in the beta position of Trp. The objective of our study was to determine the potency and selectivity generated by the added constraint in the beta position of the d-Trp upon binding to human somatostatin receptors hsst1-5. We synthesized the building blocks enantioselectively and incorporated them into the peptides by SPPS. Competition binding assays revealed that both compounds 2 and 3 were selective for hsst2 over hsst5. The (2R,3S) analog 2 was approximately 30 times more potent at hsst2 than the (2R,3R) analog 3. Interestingly, the (2R,3R) compound showed no binding affinity at hsst5.

XMODULATION IN MICEAND MEN: IL-10 PRODUCING CELLS INBLOOD AND LYMPHOID TISSUE

Background: The human immune system provides remarkable protection from a plethora of pathogens, but can cause damage when activated for a prolonged time (as inpersistent infections) or against self (autoimmunity). Therefore, mechanisms of immune system downregulation and control are imperative. There is little data on how the immune system is controlled in healthy individuals. We recently described a novel population of white blood cells that constitutively produce the immunomodulatory cytokine interleukin-10 (IL-10). Our objective was to further delineate the distribution of these cells in human and mouse models, as well as potential triggers for interleukin-10 production in vitro. Methods: Human and animal protocols were reviewed and approved by the institutional ethics board and animal care facilities, and informed consent was obtained from all human donors. The ex vivo percentage of peripheral blood CD36^+IL-10^+ mononuclear cells was assessed by intracellular flow cytometry in 10 healthy individuals. IL-10 production after exposure to twoCD36 ligands, thrombospondin and oxidized low density lipoprotein (oxLDL) was measured at 8 hours. Peripheral blood mononuclear cells and splenocytes from BL/6 (n=5) and Balb/c (n=1) micewere assessed for CD36^+IL-10^+ cells ex vivo as well. Results: The percentage of CD36^+IL-10^+ cells in peripheral blood fromhealthy individuals ranges between 0.1% and 0.9%. The percentage was similar in mouse peripheral blood, with a range of 0.4%-1.1%. These cells were also found in mouse spleen at a higher frequency than peripherally (1.1-1.5%). Human CD36^+IL-10^+ cells have more IL-10 when exposed to thrombospondin, oxLDL. Conclusions: Our novel population of IL-10 producing cells is found not only in healthy humans, but also in lymphoid tissue and blood from pathogen free mice. This highlights the evolutionary conservation of the cell across species, and suggests an important homeostatic function. The physiologic ligands for CD36 are ubiquitous in circulation, and ourin vitro data suggests a link between CD36 ligation and IL-10 production. IL-10 is a known immune system modulator, and its production by these cells may help maintain homeostaticcontrol of the immune system.

Very high and increasing incidence of type 1 diabetes mellitus in Newfoundland and Labrador, Canada

OBJECTIVE

To determine the incidence of type 1 diabetes mellitus (T1DM) among children aged 0-14 yr inclusive in the Canadian province of Newfoundland and Labrador (NL).

METHODS

Prospective and retrospective cohort study of the incidence of T1DM in children aged 0-14 yr from 1987 to 2005. Identified cases during this time period were ascertained from several sources and verified using the capture-recapture technique.

RESULTS

Over the study period, 732 children aged 0-14 yr were diagnosed with T1DM. The incidence of T1DM in this population over the period 1987-2005 inclusive was 35.08 per 100,000 (95% confidence interval: 32.54, 37.62). The incidence over this period increased linearly at the rate of 0.78 per 100 000 per year. There was a significant difference between the incidence of 31.61 per 100,000 for boys in the 0-4-yr age-group and 19.05 per 100,000 for girls in the 0-4-yr age-group (p = 0.001). The incidence was very high throughout the entire province.

CONCLUSIONS/INTERPRETATION

The province of NL has one of the highest incidences of T1DM reported worldwide. The incidence is increasing over the 19-yr study period.

Analysis of livelihood security: a case study in the Kali-Khola watershed of Nepal

This paper examines household livelihoods in highland and lowland communities of the Kali-Khola agricultural watershed in western Nepal on the basis of economic, ecological and social security indicators. Significant differences were found in soil fertility status, pests and diseases management, risk and uncertainties, use of agrochemicals and access to social services. No remarkable variations were found in crop diversification, annual agricultural income and food sufficiency. However, uncertainty and risk in agricultural production is relatively low in highland communities. The findings reveal that agriculture production alone is not a viable livelihood option for agricultural watershed communities in Nepal. The households growing crops with hired labour have relatively sustainable livelihoods in Nepal's agricultural watersheds. Insufficient agricultural land, insufficient working manpower within a family, and lack of access to ecological agricultural services are prime factors in being livelihood insecure in agricultural watershed communities. Therefore, long-term policies and plans need to be developed for the empowerment of local farmers and to support rural livelihoods with adaptable and flexible income-generating strategies, resilient resource management institutions and enhancement of knowledge, skills and social capital.

The character of anti-HCV T cell responses differs between spontaneous and treatment-induced viral clearance s

Introduction: Hepatitis C virus (HCV) is a common infection with approximately 170 million individuals infected worldwide. The majority of exposed individuals develop chronic infection, with viral clearance being the exception to the rule. Even with antiviral therapy, only 50-75% of treated individuals become HCV RNA negative. The role of the adaptive immune response, and particularly T cells, has been well established in other viral infections but its function in HCV infection is unclear, making it difficult to develop either prophylactic or therapeutic vaccine strategies. Objectives: Compare the breadth, specificity, and magnitude of anti-HCV T cell responses in individuals who are chronically HCV-infected with those who clear HCV spontaneously or after antiviral treatment. Methods: We assessed T cell responses in 3 groups of HCV exposed individuals: 18 people who were chronically HCV infected (anti-HCV antibody and HCV RNA positive), 5 who were exposed to HCV but cleared the virus without treatment (antibody positive, RNA negative), and 17 who responded to anti-HCV treatment (antibody positive but RNA negative after treatment). CD4+ T cell responses to HCV and recall antigens were measured by standard 3H-thymidine proliferation assay, and CD8+ T cell responses were evaluated by incubating peripheral blood mononuclear cells (PBMC) overnight with 15-mer peptides spanning the entire HCV-1a genome. The number of HCV-specific interferon-gamma (IFN-g)-producing cells per million PBMC was estimated by ELISPOT. Results: Anti-HCV CD4+ T cell responses were uncommon, and of low magnitude in all groups. Responses were only to peptides in the core region. The overall breadth of the anti-HCV CD8+ response was greatest in treated responders (average 43/44 peptide pools tested positive) and least in those who failed treatment (average 11/44). All clearers had responses to the NS5 region. The magnitude of the CD8+ response tended to be highest in the treated responders, but there was no significant difference between groups. Conclusions: The character of the anti-HCV T cell response differs not just between chronic infection and clearance, but also between spontaneous versus treatment-associated HCV clearance. This suggests that it is likely a combination of T cell breadth, magnitude and specificity that results in viral clearance. Based on these results, development of therapeutic and prophylactic vaccine strategies may need to target different T cell responses.

Exercise for treating anterior cruciate ligament injuries in combination with collateral ligament and meniscal damage of the knee in adults

BACKGROUND

The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee. The ACL may be damaged in isolation but often other ligaments and menisci are implicated. The injury may be managed surgically or conservatively. Injury causes pain, effusion and inflammation leading to alteration in muscle function. Regaining muscular control is essential if the individual wishes to return to pre-injury level of function and patients will invariably be referred for rehabilitation.

OBJECTIVES

To present the best evidence for effectiveness of exercise used in the treatment of ACL injuries in combination with collateral ligament and meniscal damage to the knee in adults, on return to work and pre-injury levels of activity.

SEARCH STRATEGY

We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (October 2006), Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1996 to October 2006), EMBASE (1980 to October 2006), other databases and reference lists of articles.

SELECTION CRITERIA

We included randomised controlled trials and quasi-randomised trials testing exercise programmes designed to treat adults with ACL injuries in combination with collateral ligament and meniscal damage. Included trials randomised participants to receive any combination of the following: no care, usual care, a single-exercise intervention, and multiple-exercise interventions. The primary outcome measures of interest were returning to work and return to pre-injury level of activity post treatment, at six months and one year.

DATA COLLECTION AND ANALYSIS

Two authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. Adverse effects information was collected from the trials.

MAIN RESULTS

Five trials (243 participants) evaluated different exercise programmes following ACL reconstruction and one trial (100 participants) compared supervised with self-monitored exercises as part of conservative treatment. No study compared the effect of exercise versus no exercise. Methodological quality scores varied considerably across the trials; participant and assessor blinding were poorly reported. Pooling of data was rarely possible due to the wide variety of comparisons, outcome measures and time points reported, and lack of appropriate data. Insufficient evidence was found to support the efficacy of one exercise intervention over another.

AUTHORS' CONCLUSIONS

This review has demonstrated an absence of evidence to support one form of exercise intervention over another. Further research should be considered in the form of large scale well-designed and well-reported randomised controlled trials with suitable outcome measures and surveillance periods. Suitable outcome measures should include a measure of functional outcome relevant to the individual.

Prevalence of conception and pregnancy outcomes after hematopoietic cell transplantation: report from the Bone Marrow Transplant Survivor Study

We conducted a retrospective study to describe the magnitude of compromise in reproductive function and investigate pregnancy outcomes in 619 women and partners of men treated with autologous (n=241) or allogeneic (n=378) hematopoietic cell transplantation (HCT) between 21 and 45 years of age, and surviving 2 or more years. Median age at HCT was 33.3 years and median time since HCT 7.7 years. Mailed questionnaires captured pregnancies and their outcomes (live birth, stillbirth, miscarriage). Thirty-four patients reported 54 pregnancies after HCT (26 males, 40 pregnancies; eight females, 14 pregnancies), of which 46 resulted in live births. Factors associated with reporting no conception included older age at HCT (> or =30 years: odds ratio (OR)=4.8), female sex (OR=3.0), and total body irradiation (OR=3.3). Prevalence of conception and pregnancy outcomes in HCT survivors were compared to those of 301 nearest-age siblings. Although the risk for not reporting a conception was significantly increased among HCT survivors (OR=36), survivors were not significantly more likely than siblings to report miscarriage or stillbirth (OR=0.7). Although prevalence of conception is diminished after HCT, if pregnancy does occur, outcome is likely to be favorable. Patients should be counseled prior to transplant regarding strategies to preserve fertility.

Diffusive atomistic dynamics of edge dislocations in two dimensions

The fundamental dislocation processes of glide, climb, and annihilation are studied on diffusive time scales within the framework of a continuum field theory, the phase field crystal model. Glide and climb are examined for single edge dislocations subjected to shear and compressive strain, respectively, in a two-dimensional hexagonal lattice. It is shown that the natural features of these processes are reproduced without any explicit consideration of elasticity theory or ad hoc construction of microscopic Peierls potentials. Particular attention is paid to the Peierls barrier for dislocation glide or climb and the ensuing dynamic behavior as functions of strain rate, temperature, and dislocation density. It is shown that the dynamics are accurately described by simple viscous motion equations for an overdamped point mass, where the dislocation mobility is the only adjustable parameter. The critical distance for the annihilation of two edge dislocations as a function of separation angle is also presented.

Linkage to nodal osteoarthritis: quantitative and qualitative analyses of data from a whole-genome screen identify trait-dependent susceptibility loci

OBJECTIVE

To identify susceptibility loci for nodal osteoarthritis.

METHODS

A genome screen at an average marker spacing of 9.29 cM was carried out on 558 people from 202 families, of whom 491 had nodal osteoarthritis. All genotyped people were graded for the incidence and severity of distal interphalangeal (DIP) nodes, and radiographs from 354 people were graded for joint-space narrowing (JSN) and osteophytes (OSTs). Age-regressed indices for DIP nodes, JSN and OSTs were calculated using these phenotypic data. Affected sibling pair (ASP) and quantitative trait analyses were carried out using MERLIN.

RESULTS

The data analysis identified suggestive linkage to loci on chromosomes 3 (for JSN and OST), 4 (for JSN), 8 (for DIP), 11 (for radiographic osteoarthritis) and 16 (for JSN). Both the ASP and quantitative analyses identified the loci on chromosomes 4 and 11. The loci on chromosomes 3 and 16 overlap with those previously identified for large-joint osteoarthritis. Of the loci identified by the quantitative analyses with the logarithm of the odds of linkage >1.5, two were linked to more than one trait, whereas nine were linked to single traits: one for DIP, six for JSN and two for OST.

CONCLUSION

The ASP and quantitative analyses of the cohort with nodal osteoarthritis suggest that multiple susceptibility loci for osteoarthritis influence the traits, which combine to form the osteoarthritis phenotype, and that these loci may not act exclusively on the joints of the hand.

Plant responses to potassium deficiencies: a role for potassium transport proteins

The availability of potassium to the plant is highly variable, due to complex soil dynamics, which are strongly influenced by root-soil interactions. A low plant potassium status triggers expression of high affinity K+ transporters, up-regulates some K+ channels, and activates signalling cascades, some of which are similar to those involved in wounding and other stress responses. The molecules that signal low K+ status in plants include reactive oxygen species and phytohormones, such as auxin, ethylene and jasmonic acid. Apart from up-regulation of transport proteins and adjustment of metabolic processes, potassium deprivation triggers developmental responses in roots. All these acclimation strategies enable plants to survive and compete for nutrients in a dynamic environment with a variable availability of potassium.