Epidermal γδ T cells originate from yolk sac hematopoiesis and clonally self-renew in the adult

The adult turnover mechanisms and hematopoietic origin of dendritic epidermal γδ T cells (DETCs) are poorly characterized. Gentek et al. demonstrate that DETCs originate from yolk sac hematopoiesis and clonally self-renew in the adult, akin to epidermal Langerhans cells.

The murine epidermis harbors two immune cell lineages, Langerhans cells (LCs) and γδ T cells known as dendritic epidermal T cells (DETCs). LCs develop from both early yolk sac (YS) progenitors and fetal liver monocytes before locally self-renewing in the adult. For DETCs, the mechanisms of homeostatic maintenance and their hematopoietic origin are largely unknown. Here, we exploited multicolor fate mapping systems to reveal that DETCs slowly turn over at steady state. Like for LCs, homeostatic maintenance of DETCs is achieved by clonal expansion of tissue-resident cells assembled in proliferative units. The same mechanism, albeit accelerated, facilitates DETC replenishment upon injury. Hematopoietic lineage tracing uncovered that DETCs are established independently of definitive hematopoietic stem cells and instead originate from YS hematopoiesis, again reminiscent of LCs. DETCs thus resemble LCs concerning their maintenance, replenishment mechanisms, and hematopoietic development, suggesting that the epidermal microenvironment exerts a lineage-independent influence on the initial seeding and homeostatic maintenance of its resident immune cells.

Broad and Largely Concordant Molecular Changes Characterize Tolerogenic and Immunogenic Dendritic Cell Maturation in Thymus and Periphery

Dendritic cells (DCs) are instrumental in the initiation of T cell responses, but how thymic and peripheral tolerogenic DCs differ globally from Toll-like receptor (TLR)-induced immunogenic DCs remains unclear. Here, we show that thymic XCR1(+) DCs undergo a high rate of maturation, accompanied by profound gene-expression changes that are essential for central tolerance and also happen in germ-free mice. Those changes largely overlap those occurring during tolerogenic and, more unexpectedly, TLR-induced maturation of peripheral XCR1(+) DCs, arguing against the commonly held view that tolerogenic DCs undergo incomplete maturation. Interferon-stimulated gene (ISG) expression was among the few discriminators of immunogenic and tolerogenic XCR1(+) DCs. Tolerogenic XCR1(+) thymic DCs were, however, unique in expressing ISGs known to restrain virus replication. Therefore, a broad functional convergence characterizes tolerogenic and immunogenic XCR1(+) DC maturation in the thymus and periphery, maximizing antigen presentation and signal delivery to developing and to conventional and regulatory mature T cells.

Fate mapping reveals origin and dynamics of lymph node follicular dendritic cells

The lymph node follicular dendritic cell (FDC) network is derived from the expansion and differentiation of marginal reticular cells, as are the new FDCs generated during an immune response.

Follicular dendritic cells (FDCs) regulate B cell function and development of high affinity antibody responses but little is known about their biology. FDCs associate in intricate cellular networks within secondary lymphoid organs. In vitro and ex vivo methods, therefore, allow only limited understanding of the genuine immunobiology of FDCs in their native habitat. Herein, we used various multicolor fate mapping systems to investigate the ontogeny and dynamics of lymph node (LN) FDCs in situ. We show that LN FDC networks arise from the clonal expansion and differentiation of marginal reticular cells (MRCs), a population of lymphoid stromal cells lining the LN subcapsular sinus. We further demonstrate that during an immune response, FDCs accumulate in germinal centers and that neither the recruitment of circulating progenitors nor the division of local mature FDCs significantly contributes to this accumulation. Rather, we provide evidence that newly generated FDCs also arise from the proliferation and differentiation of MRCs, thus unraveling a critical function of this poorly defined stromal cell population.

Identification of a new stromal cell type involved in the regulation of inflamed B cell follicles

Identification of a new stromal cell type in mouse lymph nodes that can be activated by B cells to delineate the transient boundaries of B cell zones during inflammation

Lymph node (LN) stromal cells provide survival signals and adhesive substrata to lymphocytes. During an immune response, B cell follicles enlarge, questioning how LN stromal cells manage these cellular demands. Herein, we used a murine fate mapping system to describe a new stromal cell type that resides in the T cell zone of resting LNs. We demonstrated that upon inflammation, B cell follicles progressively trespassed into the adjacent T cell zone and surrounded and converted these stromal cells into CXCL13 secreting cells that in return delineated the new boundaries of the growing follicle. Acute B cell ablation in inflamed LNs abolished CXCL13 secretion in these cells, while LT-β deficiency in B cells drastically affected this conversion. Altogether, we reveal the existence of a dormant stromal cell subset that can be functionally awakened by B cells to delineate the transient boundaries of their expanding territories upon inflammation.

Immune responses develop in lymphoid organs such as the tonsils and lymph nodes (LNs), which are composed of leukocytes (95%) and architectural stromal cells (5%). LNs involved in mounting an immune response recruit large numbers of lymphocytes and support the division of those that recognise the foreign antigen, raising the question of how LN stromal cells manage this tremendous remodeling. In this study, we focused on specific zones within the lymph node called germinal centres that comprise dense aggregates or follicles of B lymphocytes, and investigated how lymphoid stromal cells contribute to the reorganization of primary B cell follicles into large reactive secondary follicles. Using a fate mapping system in mice, we identified a new stromal cell type that resides in the T cell zone of noninflamed resting LNs. We demonstrate that upon inflammation, B cells usually contained within B cell follicles progressively trespass into the adjacent T cell zone and surround and convert resident stromal cells into cells that can secrete CXCL13, a B cell chemokine. These CXCL13-secreting cells in turn act to delineate the new transient boundaries of the growing follicle. Identification of this distinct versatile stromal cell type adds to our understanding of mechanisms underlying compartmentalization of lymphoid organs into their functional zones.

Multicolor fate mapping of Langerhans cell homeostasis

The adult epidermal Langerhans cell network is formed by adjacent proliferative units composed of dividing cells and their terminally differentiated daughter cells.

Langerhans cells (LCs) constitute a network of immune sentinels in the skin epidermis that is seeded during embryogenesis. Whereas the development of LCs has been extensively studied, much less is known about the homeostatic renewal of adult LCs in “nonmanipulated” animals. Here, we present a new multicolor fluorescent fate mapping system and quantification approach to investigate adult LC homeostasis. This novel approach enables us to propose and provide evidence for a model in which the adult epidermal LC network is not formed by mature coequal LCs endowed with proliferative capabilities, but rather constituted by adjacent proliferative units composed of “dividing” LCs and their terminally differentiated daughter cells. Altogether, our results demonstrate the general utility of our novel fate-mapping system to follow cell population dynamics in vivo and to establish an alternative model for LC homeostasis.

Sandfly fauna of endemic leishmaniasis foci in Anzoátegui State, Venezuela

A census of the sandfly fauna was undertaken in 1993-98 in 5 endemic leishmaniasis foci situated at different altitudes in Anzoátegui State, Venezuela. From the 17 species of Lutzomyia identified, we believe that Lu. ovallesi, Lu. panamensis and Lu. gomezi are the probable vectors of cutaneous leishmaniasis, while Lu. evansi might transmit visceral leishmaniasis.

Efficacy of ajoene in the treatment of tinea pedis: a double-blind and comparative study with terbinafine

Ajoene, an organosulfur compound originally isolated from garlic, has been shown to be effective in short-term treatment of tinea pedis. We compare the safety and effectiveness of twice-daily topical application during 1 week of 0.6% and 1% ajoene and 1% terbinafine in the treatment of tinea pedis. Seventy soldiers from the Venezuelan Armed Forces, with clinical and mycologic diagnosis of tinea pedis, were included in this study. However, only 47 were available for final evaluation. The patients were randomly distributed into 3 treatment groups: 0.6% ajoene, 1% ajoene, and 1% terbinafine. Clinical follow-up shows a rapid decline in the signs and symptoms in all groups. Efficacy of the treatments, measured as mycologic cure, 60 days after the end of the therapy was 72% for 0.6% ajoene, 100% for 1% ajoene, and 94% for 1% terbinafine. This represents the first demonstration of the therapeutic application of an inhibitor of phospholipid biosynthesis in human dermatophytosis.

What is the role of psychotherapy in the treatment of bipolar disorder?

BACKGROUND

The authors review and criticize the different roles developed by psychotherapy in the treatment of bipolar disorder, from psychodynamic conceptions to a biopsychosocial model.

METHODS

The main computerized database (Medline, Current Contents, Psychological Abstracts) have been consulted, using the terms 'psychotherapy', 'psychosocial' and 'bipolar disorder' as key words.

RESULTS

Psychoanalysis, psychoeducation, family therapy, cognitive-behavioral therapy and interpersonal therapy have been used in the treatment of bipolar patients. To date, none have established efficacy in controlled clinical trials regarding aspects such as hospitalization, recurrences or suicidal behavior, as medication alone does. Research on this issue usually undergoes methodological pitfalls. Nonetheless, the psychoeducative approach combined with several cognitive-behavioral techniques, either in group or individually, seem to be the most promising, focusing on information, treatment compliance, and illness management skills.

CONCLUSIONS

There is a need for systematic clinical research on psychotherapy applied to bipolar disorder in order to show its true usefulness. Psychoeducation should prove its positive influence on the course and outcome of bipolar disorder.

Seasonal and nocturnal domiciliary human landing/biting behaviour of Lutzomyia (Lutzomyia) evansi and Lutzomyia (Psychodopygus) panamensis (Diptera; Psychodidae) in a periurban area of a city on the Caribbean coast of eastern Venezuela (Barcelona; Anzoátegui State)

In recent years, in addition to American cutaneous leishmaniasis (ACL), a significant number of cases of American visceral leishmaniasis (AVL) have been reported in periurban areas of Barcelona city (Anzoátegui State, Venezuela). We studied the bionomics of Lutzomyia (Lutzomyia) evansi and Lutzomyia (Psychodopygus) panamensis, possible vectors of AVL and ACL, respectively, in El Rincón, a periurban village of that city. To evaluate the seasonal domiciliary landing/biting activity of sandflies on human bait, a house was chosen in El Rincón. Landing catches were carried out between 18:00 and 06:00, once a month for a year. The results show the presence of 2 species, Lu. (Lu.) evansi (89.9%) and Lu. (Psy.) panamensis (10.1%). Lu. evansi was most abundant in the months of October and July, associated with the bimodal cycle of annual rainfall in the area. Maximum landing/biting activity of Lu. evansi was observed at 24:00 and 03:00. These findings suggest that at this time of the year and at these hours there is heightened risk of the transmission of AVL. Lu. panamensis monthly abundance also shows a direct association with rainfall and maximum landing/biting activity was observed between 02:00 and 03:00. The lower domiciliary abundance of Lu. panamensis suggests its greater importance in the extradomiciliary transmission of ACL.

Ajoene in the topical short-term treatment of tinea cruris and tinea corporis in humans. Randomized comparative study with terbinafine

Ajoene (CAS 92284-99-6), an organic trisulphur originally isolated from garlic, has an antimycotic activity which has been widely demonstrated both in vitro and in vivo. The objective of this work was to compare the safety and effectiveness of ajoene (0.6%, gel) with terbinafine (CAS 91161-71-6) (1%, cream) for the treatment of tinea corporis and tinea cruris. The patients selected were 60 soldiers with clinical and mycological diagnosis of either dermatophytosis. They were distributed at random in two treatment groups, one treated with ajoene at 0.6% and the other with terbinafine at 1%. All patients were evaluated clinically and mycologically 30 and 60 days after completion of the treatment, which was considered effective when clinical signs and symptoms had disappeared and the mycological cultures were negative. Thirty days after treatment, the percent healing rate was 77 and 75 for the groups treated with ajoene and terbinafine, respectively. Sixty days after treatment, the healing rate 73% and 71% for the groups treated with ajoene and terbinafine, respectively. These results and those obtained in previous studies confirm that ajoene is a new agent for the topic treatment of superficial mycoses, and for the first time show the therapeutic usefulness of an inhibitor of phospholipids biosynthesis in eukaryotes.

Epidemiologic characterization of American cutaneous leishmaniasis in an endemic region of eastern Venezuela

The status of American cutaneous leishmaniasis was investigated from 1985 to 1991 to provide an epidemiologic characterization of the disease in Bergantin, a rural community in the northeastern part of Anzoátegui State, Venezuela. The study revealed the presence of the infection during the period analyzed, with an average incidence of 50.2 cases per 10,000 inhabitants and this number has increased 1.5 times during the last two years. Three villages where clinical cases had been recorded were selected for a comparison of their prevalence data. These villages comprise the human population in the high and low altitude limits of Bergantin. Immunologic assessment of the inhabitants used two different antigen preparations to examine responses to parasites associated with the cutaneous and visceral forms of the disease. The leishmanin skin test (LST) was used in a sample of 276 individuals (46.3% of the inhabitants) and resulted in an overall positivity of 16.7%. The percentage of LST positivity varied with age and sex, yet analysis of this response and the prevalence for each village reflected the specific characteristics of these localities. La Montaña, situated at 800 meters above sea level, had the highest prevalence (800 cases per 10,000 inhabitants) and the most positive LST response (21.2%) in comparison with the two other villages situated at a lower altitude (300 meters above sea level).

Efficacy of ajoene, an organosulphur derived from garlic, in the short-term therapy of tinea pedis

The present report shows the efficacy of ajoene, a garlic-derived organic trisulphur, for short-term therapy of tinea pedis. The use of ajoene as a 0.4% (w/w) cream resulted in complete clinical and mycological cure in 27 of 34 patients (79%) after 7 days of treatment. The remaining seven patients (21%) achieved complete cure after seven additional days of treatment. All patients were evaluated for recurrence of mycotic infections 90 days after the end of treatment, yielding negative cultures for fungus. These results show that ajoene is an alternative, efficient and low-cost antimycotic drug for short-term therapy of tinea pedis. The fact that ajoene can be easily prepared from an alcoholic extract of garlic may make it suitable for Third World public health care.

Characterization of GTP-gamma-S binding to isolated human platelet plasma membranes and its relationship with the stimulation of a phospholipase C activity

Binding parameters for the interaction of GTP-gamma-[35S] with isolated platelet plasma membranes have been studied. Analysis of the data by a non-linear curve fitting program indicates that the interaction can be satisfactory described by a model with a single, high affinity binding site (Kd = 0.3 +/- 0.07 microM and Bm = 0.4 +/- 0.2 nmoles of GTP-gamma-S/mg of membrane protein). Binding is selectively inhibited by GDP-beta-S and GMP-PNP (1 microM), but not affected by ATP, CTP, ITP, or UTP, even at mM concentration. Optimal conditions for the interaction were 30 degrees C and pH 8.0. Incubation of the isolated membranes with GTP-gamma-S results in a measurable phospholipase C activity (as detected both by a breakdown of phosphoinositides and an increase of inositide phosphates) which under our experimental conditions is only slightly enhanced by addition of cytosolic proteins. Our results indicate that platelet plasma membranes contain all the necessary elements for signal transduction through the diacylglycerol/inositolphosphates pathway.

Reversible prevention of platelet activation by (E,Z)-4,5,9-trithiadodeca-1,6,11-triene 9-oxide (ajoene) in dogs under extracorporeal circulation

Ajoene ((E,Z)-4,5,9-trithiadodeca-1,6,11-triene 9-oxide), an organosulfur compound derived from garlic inhibits platelet activation induced ex vivo by all known agonists. The effect of ajoene on the thrombocytopenia associated with the circulation of blood through extracorporeal devices such as dialyzers or oxygenators was studied under the following conditions: Ex vivo using fresh, heparinized human blood, circulating through a dialyzer or oxygenator, and in vivo, in dogs subjected to extracorporeal circulation. In both experimental conditions ajoene proved very efficacious in preventing platelet loss (60-65% loss in controls vs. 15-20% loss in the presence of ajoene, p less than 0.01). Moreover, recuperation of platelet function was achieved after 3-4 h in the in vivo experiments.