Mechanisms of eosinophil recruitment

As with other types of leukocytes, mechanisms that function to enable the recruitment of eosinophils into specific sites of immune reactions involve a complex and cumulative interplay of many molecules and pathways. No single chemoattractant is specific for eosinophils, but rather various chemoattractants active on eosinophils can also elicit migration of other specific cell types. Humoral mediators causing eosinophil migration include C5a and platelet-activating factor, whereas cytokines active as eosinophil chemoattractants include interleukin (IL)-2, IL-3, IL-5, granulocyte/macrophage colony-stimulating factor, lymphocyte chemoattractant factor, and RANTES. Eosinophils utilize several pathways to adhere to vascular endothelial cells, including binding to intercellular adhesion molecule-1, E-selectin, and vascular cell adhesion molecule-1 (VCAM-1). The lack of binding of neutrophils to VCAM-1 and the enhanced expression of VCAM-1 elicited by IL-4 contribute to preferential eosinophil accumulation. Eosinophil recruitment is dependent not only on ligands expressed on eosinophils and molecules inducible on endothelial cells but also on processes active during transendothelial migration and extravascular migration in the extracellular spaces.     

Elevated interleukin-10-to-interleukin-12 ratio in feline immunodeficiency virus-infected cats predicts loss of type 1 immunity to Toxoplasma gondii

Similar to human immunodeficiency virus, feline immunodeficiency virus (FIV) induces immunodeficiency and enhanced susceptibility to secondary pathogens. To explore cytokine alterations in lentivirus immunodeficiency, constitutive mRNA expression was measured in lymph nodes of healthy and FIV-infected cats before and after challenge with Toxoplasma gondii. Cytokine mRNA expression was similar in control and FIV-infected cats during the first 10 weeks after infection. At 16 weeks, interferon (IFN)-gamma, tumor necrosis factor-alpha, and interleukin (IL)-10 mRNA were increased in FIV-infected cats. Challenge with T. gondii induced an increase in IL-2, IFN-gamma, and IL-12 in the lymph nodes of control cats, whereas IFN-gamma and IL-10 but not IL-2 or IL-12 increased in the lymph nodes of FIV-T. gondii coinfected cats. These results indicate that FIV immunodeficiency may derive from a failure to generate an IL-12-dependent type 1 response and that an elevated level of IL-10 mRNA expression is a predictor of lentivirus immunodeficiency.     

Leisure and occupational physical activity and risk of colorectal adenomatous polyps

Multiple studies have shown a protective effect for physical activity on the incidence of colorectal cancer, but few have addressed its association with incident adenomas and none have investigated its association with metachronous adenomas. We interviewed 2,001 patients undergoing colonoscopy in 3 New York City practices between 1986-1988. Of these, 298 had a first diagnosis of adenomas, 506 had normal colonoscopies, 197 had metachronous adenomas and 345 had normal colonoscopies with a past history of adenomas. Subjects were queried regarding use of moderate amounts of recreational exercise (swimming, jogging, biking, racket sports and other sports) on a regular basis, and were also asked to estimate their level of physical activity. Occupational physical activity was assessed through a blinded coding of occupational titles. After adjusting for age, years of education, body mass index, total caloric intake, dietary fiber intake, dietary fat intake and years of cigarette smoking, protective effects of borderline significance were observed among males for leisure physical activity for metachronous and incident cases. Occupational physical activity was found to be significantly protective in male incident cases. Men with increased levels of either occupational or leisure activity showed a reduction for incident and metachronous cases. No effects were observed for females. Thus, in this study, both leisure and occupational physical activity were associated with a reduced risk of incident and metachronous adenomas among men but not women.     

Measures of disease activity and damage in SLE

Criteria for the classification of systemic lupus erythematosus (SLE) are not sufficient to describe the degree of disease activity. Several instruments to assess disease activity have been developed. This chapter reviews the derivation, validation, and clinical application of current disease activity measures in SLE, as well as comparison among them. As patients with lupus survive longer, the sequelae of the disease activity and its therapy are becoming more common. The derivation and validation of the single, generally accepted SLICC/ACR damage index is also discussed.     

Brain Lesion Volume and Neuropsychological Function Predict Efficacy of Treatment for Depression in Multiple Sclerosis.

This study examined the effects of brain lesions and neuropsychological impairment on the efficacy of treatment for depression in patients with comorbid diagnoses of multiple sclerosis (MS) and major depressive disorder (MDD). Thirty patients meeting criteria for MS and MDD received 1 of 3 16-week treatments for depression and were followed for 6 months following treatment cessation. T2-weighted magnetic resonance imaging and neuropsychological evaluations were also obtained. End-of-treatment Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) results residualized for baseline BDI were related to right temporal periventricular lesion volume (R2=.32, p=.002) and left temporal grey-white junction lesion volume (R2=.19, p=.02) but were not statistically related to lesion volume in any other brain region or to neuropsychological function. BDI results at 6-month follow-up, residualized for end-of-treatment BDI, were predicted by total lesion volume (R2=.22, p=.005), lesion volume in many discrete areas, and neuropsychological functioning (R2=.29, p=.0009). The effect of total lesion volume on 6-month follow-up BDI results was fully mediated by neuropsychological function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

New approaches to syphilis control. Finding opportunities for syphilis treatment and congenital syphilis prevention in a women's correctional setting

BACKGROUND: With prostitution and drugs the most common reasons for arrest among New York City (NYC) women, female arrestees are at high risk for acquiring syphilis and delivering congenitally infected babies. Despite routine syphilis screening of all NYC inmates, many are released before the need for treatment is recognized, and once released, few could be found for treatment. GOALS: To improve syphilis treatment rates among female correctional inmates in NYC. STUDY DESIGN: At a women's correctional health clinic, on-site, rapid, qualitative nontreponemal syphilis testing (STAT rapid plasma reagin [RPR]) and on-line access to the local syphilis case registry were introduced to supplement the usual admission medical evaluation. Treatment decisions made using the authors' jail protocol were compared with treatment criteria used in NYC's sexually transmitted disease (STD) clinics. Patients consisted of a consecutive sample of 685 remandees admitted one or more times during the day shift, March 24, 1993, to July 31, 1993, who had a full complement of mandatory admission medical tests. Using the study protocol, syphilis treatment decisions were made and needed treatment was furnished at the end of the admission medical evaluation. The main outcome measures were correct identification and treatment of syphilis in this population, compared with standard NYC Department of Health (DOH) STD clinic practice, as well as the effect of the jail protocol on pregnancy outcomes and need to treat offspring for congenital syphilis. RESULTS: Compared with NYC DOH STD clinic practice, the study protocol was 95% sensitive and 88% specific in arriving at appropriate treatment for syphilis. Treatment at the end of the admission medical evaluation increased syphilis treatment rates from 7% to 84% of women with indications for treatment and to 88% of pregnant women with indications for treatment. Prospective follow-up for birth outcomes revealed no spontaneous abortions and eight live births. Seven of the eight did not need congenital syphilis treatment because their mothers were adequately treated while incarcerated. CONCLUSIONS: Qualitative (or STAT) RPR testing and access to DOH syphilis case registry data provide prompt and accurate diagnostic information that can lead to an overall increase in the number of inmates appropriately treated (with a minimum amoung of overtreatment) in a women's correctional facility. This protocol may be applicable in other high-risk, transient populations.     

A baseline assessment of cigarette sales to minors in San Diego, California

A community-wide survey of 302 parents of 2-year-old children and 90 private medical practitioners in a large midwestern city revealed low immunization rates (31%) and differences in parent and provider perceptions of barriers to preschool immunizations. Parents most frequently identified barriers of system factors such as cost, lack of insurance coverage, and long office waits. System barriers were reported across differing sources of immunizations (private physician as well as public clinics) and were pervasive across income groups. Providers were more likely to report barriers of parental difficulties with forgetting immunizations or not knowing when the immunizations were due. Even though providers identified parental shortcomings with scheduling as problematic, only one fifth employed tracking and reminder systems. Implications of findings for modifications of the delivery of immunization services and for parent education are discussed.