[Analysis on causes of death of residents in Beijing, 1965-1974]

OBJECTIVE

To fill up the absence of data on causes of death of urban residents in Beijing during 1965-1974 and provide evidence for the similar study in other areas.

METHODS

All possible sources for death data during 1965-1974 were identified through expert consultations and record search. Stratified sampling was conducted to collect the death data of urban residents during this period in Beijing. The mortality rate, death cause constituent and rank of death causes were used in this descriptive analysis.

RESULTS

A total of 11 668 records of deaths from 1965 to 1974 were collected from 10 local police stations in urban area of Beijing. The top 10 death causes in the urban residents were heart disease, tumor, cerebrovascular disease, accidental injury, respiratory system disease, digestive system disease, communicable disease and parasitic disease, nervous system disease, urogenital and reproductive system disease, endocrine and nutrition metabolic diseases. The deaths caused by these diseases accounted for 84.19% of the total deaths. Accidental injury accounted for 13.22% of the total deaths, which was significantly higher than that in either 1964 or 1975, two years before and after this period(P<0.01). Suicide accounted for 54.47% of the total accidental injury deaths. For men, accidental injury was the leading death cause, followed by cancer and heart disease; for women, heart disease, cancer and cerebrovascular disease were the top three death causes.

CONCLUSION

The major death cause in urban residents changed from infectious diseases to chronic and non-communicable diseases during 1965-1974. A remarkable high proportion of deaths caused by accidental injury was due to the historical background during that period in Beijing, China.

Development of a valid Simplified Chinese version of the International Hip Outcome Tool (SC-iHOT-33) in young patients having total hip arthroplasty

OBJECTIVE

The International Hip Outcome Tool (iHOT-33) is a questionnaire designed for young, active patients with hip disorders. It has proven to be a highly reliable and valid questionnaire. The main purpose of our study was to adapt the iHOT-33 questionnaire into simplified Chinese and to assess its psychometric properties in Chinese patients.

METHOD

The iHOT-33 was cross culturally adapted into Chinese and 138 patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the EuroQol-5D (EQ-5D), and the Chinese version of the iHOT-33(SC-iHOT-33) pre- or postoperatively within 6 months' follow-up. The Cronbach's alpha, intraclass correlation coefficient (ICC), Pearson's correlation coefficient (r), effect size (ES), and standardized response mean (SRM) were calculated to assess the reliability, validity, and responsiveness of the SC-iHOT-33, respectively.

RESULTS

Total Cronbach's alpha was 0.965, which represented excellent internal consistency of the SC-iHOT-33. The ICC ranges from 0.866 to 0.929, which shows excellent test-retest reliability. The subscales of SC-iHOT-33 had the highest correlation coefficient (r = 0.812) with the physical function subscales of the WOMAC, as well as good correlation between the social/emotional subscale of the SC-iHOT-33 and the EQ-5D (r = 0.740, r = 0.743). No floor or ceiling effects were found. The ES and SRM values indicated good responsiveness of 2.44 and 2.67, respectively.

CONCLUSION

The SC-iHOT-33 questionnaire is reliable, valid, and responsive for the evaluation of young, Chinese, active patients with hip disorders.

NtBRC1 suppresses axillary branching in tobacco after decapitation

Axillary branching is controlled by a very complex mechanism involving various endogenous and environmental factors. Previous studies have shown that Tb1/BRC1 is the point of integration in the network of molecular mechanisms regulating axillary branching in plants. In this study, we cloned the Tb1/BRC1 ortholog, NtBRC1, from Nicotiana tabacum and functionally analyzed its role in the control of axillary branching in tobacco. Overexpression of NtBRC1 resulted in significant retardation of axillary branching, and downregulation of this gene resulted in significant acceleration of axillary branching after decapitation. This indicates a negative role for this gene in the regulation of axillary branching. In-line with previous reports, NtBRC1 was found to be expressed predominantly in axillary buds. Additionally, as expected, expression was decreased 8 h following decapitation, which further confirms its role in the suppression of axillary branching. Furthermore, the expression of NtBRC1 was significantly downregulated by cytokinin, but was not affected by GR24, a synthetic strigolactone. Based on the data collected in the present study, we demonstrate that NtBRC1 negatively regulates axillary branching in tobacco after decapitation and functions downstream of the cytokinin signaling pathway inside axillary buds.

The clinical outcomes of triple antiplatelet therapy versus dual antiplatelet therapy for high-risk patients after coronary stent implantation: a meta-analysis of 11 clinical trials and 9,553 patients

Background

The optimal antiplatelet regimen after in-coronary intervention among patients presenting with complex coronary artery lesions or acute coronary syndrome (ACS) has remained unclear. This study sought to evaluate the clinical outcomes of triple antiplatelet treatment (TAPT) (cilostazol added to aspirin plus clopidogrel) in these patients.

Methods

The PubMed, EMBASE, MEDLINE, and other Internet sources were searched for relevant articles. The primary end point was major adverse cardiac events (MACE), including all-cause mortality, myocardial infarction, and target vessel revascularization. The incidence of definite/probable stent thrombosis and bleeding were analyzed as the safety end points.

Results

Eleven clinical trials involving 9,553 patients were analyzed. The risk of MACE was significantly decreased following TAPT after stent implantation in the ACS subgroup (odds ratio [OR]: 0.72; 95% confidence interval [CI]: 0.61–0.85; P<0.001), which might mainly result from the lower risk of all-cause mortality in this subset (OR: 0.62; 95% CI: 0.48–0.80; P<0.001). The risk of bleeding was not increased with respect to TAPT.

Conclusion

TAPT after stent implantation was associated with feasible benefits on reducing the risk of MACE, especially on reducing the incidence of all-cause mortality among patients suffering from ACS, without higher incidence of bleeding. Larger and more powerful randomized trials are still warranted to prove the superiority of TAPT for such patients.

[Influencing factors on healthy life expectancy in adults in Beijing]

OBJECTIVE

To understand the main influencing factors related to healthy life expectancy (HALE) among adults in Beijing.

METHODS

The calculation on health-adjusted life expectancy was performed by Sullivan METHODS. Data from the self-reported health survey program on adults in Beijing 2012 was gathered. Hierarchical ordered probit model was used to estimate the severity-weighted prevalence of disability and then combined with the period life table to obtain the HALE. Factors associated with the severity-adjusted prevalence of the disabled were analyzed under the generalized additive models (GAM).

RESULTS

The main influencing factors of HALE would include age (t=40.351, P<0.001), sex (t=9.689, P<0.001), levels of education (t=5.021, P< 0.001), exercise (t=5.487, P<0.001) and alcohol intake (t=-2.380, P=0.017) etc. The influence of per capita monthly income (χ(2) =3.949, P=0.044) showed as non-linear.

CONCLUSIONS

Levels of income would directly influence the severity-weighted prevalence of the disability, which also affecting the HALE. Programs on improving healthy life style and health care in women should be promoted.

Cloning, characterization, expression, and feeding response of thyrotropin receptor in largemouth bass (Micropterus salmoides)

Thyrotropin receptor (TSHR) is a G-protein-coupled receptor that regulates the synthesis, storage, and secretion of thyroid hormones in the thyroid tissue. The aims of the present study were to characterize the full-length TSHR cDNA in largemouth bass (Micropterus salmoides), and to determine the TSHR gene transcription levels in different tissues. In addition, the response of TSHR transcription levels to daily feeding in thyroid tissue was investigated. The results showed that the full-length cDNA sequence was 2743 bp with an open reading frame of 2340 bp encoding a 779-amino acid peptide. BLAST analysis indicated that the amino acid sequence displayed 58.4-90.2% identity and 5.6-125.8 divergence, compared with other known fish species. The most abundant TSHR transcription levels were found in the spleen, head kidney, and kidney. Feeding did not affect the transcription level of TSHR in thyroid tissue over the course of the day. Thus, the current study suggests that there was no relationship between daily nutritional status and TSHR transcription level in the thyroid tissue of largemouth bass. The spleen, head kidney, and kidney exhibited the most abundant TSHR transcription levels.

The expression of osteopontin in breast cancer tissue and its relationship with p21ras and CD44V6 expression

OBJECTIVE

This study aimed to investigate the expression of osteopontin (OPN), p2lras, and CD44V6 in breast cancer tissues, and to analyze the relationships between their expression and a patient's clinicopathological characteristics and five-year survival rate.

MATERIALS AND METHODS

Streptavidin-peroxidase immunohistochemistry was used to detect the expression of OPN, p2lras, and CD44V6 in tissue samples from 96 breast cancer patients, and the multivariate Cox proportional hazards model (mCOX-PHM) was used to analyze the factors that affect prognosis.

RESULTS

Among the 96 breast cancer patients studied, positive staining for OPN, CD44V6, and p21ras was observed in 54.2%, 58.3%, and 43.8% of samples, respectively. The expression of OPN and CD44V6 were positively correlated (r = 0.58), and the expression of OPN and p21ras were also positively correlated (r = 0.25). Coexpression OPN, CD44V6, and p21ras was negatively correlated with a patient's five-year survival rate (p < 0.05). Kaplan-Meier analysis indicated that a patient without OPN, CD44V6, or p21ras expression had an improved survival (p < 0.05). Results from the mCOX-PHM analysis indicated that CD44V6 expression, the degree of tumor differentiation, and lymph node metastasis were all independent factors that indicate prognosis. The combined detection of OPN, CD44V6, and p21ras could contribute to a more accurate assessment of the biological behavior of breast cancers, and could help to indicate the prognosis of breast cancer patients.

Quality of life of Chinese urologists: a cross-sectional study using WHOQOL-BREF

OBJECTIVES

In recent years, Chinese hospital settings are under violent threats. The exact status of quality of life of Chinese doctors under these disastrous situations remains obscure. The aim of this study was to assess the quality of life of Chinese urologists and analyse its potential affecting factors.

DESIGN

Cross-sectional survey.

SETTING

Beijing, China.

PARTICIPANTS

Overall, 1000 participants from more than 30 areas of China, who participated in the 20th National Urology Conference in Beijing in 2013, were surveyed. The brief version of the World Health Organization Quality of Life (WHOQOL-BREF) Chinese version was used to assess the quality of life among these urologists. The relationship between quality of life and the affecting factors was analysed.

RESULTS

Of the 1000 questionnaires, 856 were completed and returned, and 708 questionnaires were valid for analysis. Approximately 46% of the respondents came from provincial capitals, 54.2% of them felt stress from medical environment, while 76.0% felt stress from research work, and 85.3% from promotion. Cronbach's α coefficient of the instrument was 0.825, Kaiser-Meyer-Olkin measure was 0.841, and P value of Bartlett's sphericity was <0.001. The results of binary logistic regression indicated gender, work years, and medical environment as potential affecting factors of quality of life only influenced one domain. In contrast, research work and promotion influenced three domains of the WHOQOL-BREF.

CONCLUSIONS

The study indicated that the WHOQOL-BREF may be a reliable and valid tool to assess quality of life of Chinese urologists. In China it is true that the deteriorative medical environment negatively affects medical practice according to previous studies, and policies are recommended to improve the situation. Nevertheless, we should not be too pessimistic about it, as in today's context research work and promotion may be the most extensive and significant affecting factors on doctors' quality of life.

Initial experiences with laparoscopy and flexible ureteroscopy combination pyeloplasty in management of ectopic pelvic kidney with stone and ureter-pelvic junction obstruction

To demonstrate the safety and efficacy of combine laparoscopy and flexible ureteroscopy to treat ectopic pelvic kidneys with ureteropelvic junction obstruction (UPJO) and stones. 16 patients of ectopic pelvic kidneys with ureteropelvic junction obstruction and stones were treated with laparoscopy and flexible ureteroscopy (FURS). The operative time, required dose of tramadol, visual analog pain scale (VAPS), postoperative day, stone-free rates (SFRs), perioperative complications, and serum creatinine were evaluated. The SFRs were evaluated with noncontrasted renal computed tomography (CT). Intravenous pyelography (IVP) and CT scan were used to evaluate the UPJO. Stone-free status was defined as absence of stone fragments in kidney or the size of that is less than 3 mm. Operation time from 118 to 225 min, average time (171 ± 28) min; lithotomy time from 16 to 45 min, average time (32 ± 6) min. Average tramadol required at the first day postoperation was (118 ± 49.6) mg; at the second day was (78 ± 24.8) mg. VAPS score at 24 h (5.0 ± 0.7), VAPS score at 48 h (2.5 ± 0.8). Postoperative day (3.9 ± 0.6) days. Stone-free rate was 100%. Average serum creatinine was (88.7 ± 24.3) mol/L before surgery and (92.8 ± 21.6) mol/L after surgery. No major complication. No stone and obstruction recurrence in the follow-up of average 29.3 months. Combined FUR and LC is a good option for patient of ectopic pelvic kidney with renal stone and UPJO. From our initial experience, the SFRs and the effect of pyeloplasty are satisfactory and without major complication, the operative time is acceptable.

Ischemia-reperfusion injury in an aortic dissection patient

Aortic dissection is a life-threatening emergency. Well-established risk factors include systemic hypertension, hereditary connective tissue diseases (Marfan syndrome and Ehlers-Danlos syndrome), coarctation of the aorta, bicuspid aortic valve, aortitis, and arch hypoplasia. Ischemia of the viscera, the kidneys, the spinal cord, or the lower extremities due to malperfusion constitutes life-threatening complications that have to be considered in the treatment strategy.We report a rare case of symptomatic ischemia of the lower extremities due to aortic dissection. This case demonstrates that the treating physician needs to be vigilant for ischemia reperfusion injuries such as osteofascial compartment syndrome and acute renal failure in aortic dissection.

Correlation between atomic structure evolution and strength in a bulk metallic glass at cryogenic temperature

A model Zr_41.25Ti_13.75Ni₁₀Cu_12.5Be_22.5 (at.%) bulk metallic glass (BMG) is selected to explore the structural evolution on the atomic scale with decreasing temperature down to cryogenic level using high energy X-ray synchrotron radiation. We discover a close correlation between the atomic structure evolution and the strength of the BMG and find out that the activation energy increment of the concordantly atomic shifting at lower temperature is the main factor influencing the strength. Our results might provide a fundamental understanding of the atomic-scale structure evolution and may bridge the gap between the atomic-scale physics and the macro-scale fracture strength for BMGs.

Transmission of Babesia sp to sheep with field-collected Haemaphysalis qinghaiensis

Haemaphysalis qinghaiensis ticks collected in the Gannan Tibet Autonomous Region were infested onto a sheep from a Babesia-free area. A strain of small Babesia (1.8-2.1 microm in length) was isolated from the sheep. Most of the Babesia in erythrocytes were round, oval, single pyriform, double pyriform, budding or elongated in form. Measurements were made of 100 single sides of the double-pyriform Babesia and compared with those for B. motasi and B. ovis from Holland, using Student's t-test. The Gannan small Babesia was similar to the B. ovis from Holland, but differed significantly from the Dutch B. motasi.

Development of an enzyme-linked immunosorbent assay for the diagnosis of Theileria sp. infection in sheep

A rapid, sensitive and specific diagnostic method, an enzyme-linked immunosorbent assay (ELISA), was developed for the diagnosis of Theileria sp. infection in sheep; and optimal conditions were established, such as antigen concentration, serum dilution, coating time, Tween-20 concentration and conjugate. The results were analyzed by measuring the coefficient of variation (CV). Three sera titers (high, middle, low) were analyzed over the measurement range, resulting in a CV of around 10%, whereas a 30% variation is the maximum acceptable. The cut-off value was determined by the mean of a negative control plus three standard deviations. Cross-reaction was found only with Babesia ovis. However, this result may be questionable, because it cannot be excluded that these sheep were already infected with both Theileria sp. and B. ovis. The ELISA described in the present study proved to be a useful tool for studying the epidemiology of Theileria sp.

A field test on the treatment of ovine theileriosis with an injection of Kangjiaoming

A compound effective for the treatment of ovine theileriosis was selected and a slow-release preparation (named Kangjiaoming) was prepared. A total of 1,172 sheep and goats in Zhangjiachuan, Lintan and Yuzhong Counties, Gansu Province, where small ruminants are seriously affected by theileriosis, were injected with this preparation at a dosage of 5 mg/kg body weight. The infection rate of the control group in each of the above-mentioned counties was 98.5%, 85% and 80%, respectively. None of the treated animals became sick due to theileriosis. This drug proved to be useful for the treatment of carrier cases, although its effect was apparently slower than in acute theileriosis. The effect of the preparation on some weak animals was not satisfactory.

gammadelta T cells express activation markers in the central nervous system of mice with chronic-relapsing experimental autoimmune encephalomyelitis

In this study, we assessed the expression of activation markers on gammadelta T cells in central nervous system (CNS) lesions of SJL mice adoptively sensitized to develop experimental autoimmune encephalomyelitis (EAE) using myelin basic protein-reactive T cells. Although disease expression is known to be dependent upon T cells that express the alphabeta T cell receptor (TCR), a role for gammadelta T cells has been implicated in some studies but not in others. Using three-color flow cytometric analysis of both total and gammadelta T cells in spleen and CNS, the data showed that expression of CD69 (early activation marker), CD62L (lymphocyte homing receptor), CD25 (IL-2Ralpha), CD122 (IL-2Rbeta) and CD95/CD95L (Fas/FasL), fluctuated on gammadelta T cells in EAE lesions in a disease-related fashion. Furthermore, the pattern of expression for these markers on gammadelta T cells was distinct from that found on the total lymphocyte population. Cytokine analysis of gammadelta T cells in the CNS demonstrated a bias towards a Th1-like cytokine profile. From these data, we conclude that gammadelta T cells in EAE lesions display an activated phenotype and form a dynamic component of the total lymphocyte population in the CNS, supporting a contributory role for these cells.

A comparison of calcitonin gene-related peptide effects on coronary flow and cardiac conduction system in the guinea pig

The purpose of this study was to examine the effects of calcitonin gene-related peptide (CGRP) on coronary flow and various parts of cardiac conduction system (CCS) in the isolated guinea pig heart by recording the cardiac electrogram and His bundle activity simultaneously. The coronary flow (CF) was measured and the right atrium was paced at incremental frequencies periodically. Perfusing heart with CGRP at the concentrations of 3 30 nmol/L increased CF strikingly and dose-dependently. CGRP (30 nmol/L) caused a moderate and significant increase in the spontaneous heart rate, but failed to influence the atrioventricular nodal and His bundle-Purkinje fiber conduction time and the longest atrial pacing cycle length inducing 3 2 Wenckebach and 2 1 AV nodal conduction. The results indicate that CGRP in the guinea pig heart might act mainly on coronary vessels and then the sinus node, but did not affect the conductivity and refractoriness of the AV conduction system.

Neuregulin in neuron/glial interactions in the central nervous system. GGF2 diminishes autoimmune demyelination, promotes oligodendrocyte progenitor expansion, and enhances remyelination

Glial growth factor 2 (GGF2) is a neuronal signal that promotes the proliferation and survival of the oligodendrocyte, the myelinating cell of the central nervous system (CNS). This study has focused on recombinant human GGF2 (rhGGF2) and it's potential to affect clinical recovery and repair to damaged myelin in chronic relapsing experimental autoimmune encephalomyelitis (EAE) in the mouse, a major animal model for the human demyelinating disease, multiple sclerosis (MS). Mice with EAE were treated with rhGGF2 during both the acute and relapsing phases, and GGF2 treatment led to delayed signs, decreased severity and resulted in statistically significant reductions in relapse rate. Further, rhGGF2-treated groups displayed CNS lesions with more remyelination than in controls. This correlated with increased expression of myelin basic protein exon 2, a marker for remyelination, and with an increase of the regulatory cytokine, IL-10. Thus, a beneficial effect of a neurotrophic growth factor has been demonstrated upon the clinical, pathologic and molecular manifestations of autoimmune demyelination, an effect that was associated with increased expression of a Th2 cytokine. rhGGF2 treatment may represent a novel approach to the treatment of MS (Cannella et al., 1998).

Evidence for gammadelta T cells with a restricted Vgamma6 junctional region in the normal mouse central nervous system

In this study we present evidence that gammadelta T cells are present in the normal mouse central nervous system (CNS). Compared with matching spleen gammadelta T cells, CNS gammadelta T cells expressed only the CD45RBlow phenotype, suggesting that CNS gammadelta T cells belong to the memory cell population. Approximately 20% expressed exclusively the CD8alphabeta heterodimer, consistent with a thymic origin. Gammadelta T cells in both spleen and CNS expressed higher levels of the IL-2rbeta (CD122), as well as Fas and FasL, than alphabeta T cells, suggesting that these cells function as immunoregulatory T cells. RT-PCR analysis showed almost exclusive use of Vdelta6 in the CNS whereas more Vdelta genes were expressed in the spleen. Sequencing of Vdelta6 RT-PCR products demonstrated a polyclonal population of T cells in the spleen but a more clonal population within the CNS. The predominant CNS sequence was found in all animals studied and was also detected in the spleen. From these data we conclude that a selective component of circulating gammadelta T cells traffics through the CNS. Thus, all major populations of lymphocytes can be detected in the normal CNS and as such may play specific roles in the immunological surveillance of that organ.

Heat shock proteins and experimental autoimmune encephalomyelitis. II: environmental infection and extra-neuraxial inflammation alter the course of chronic relapsing encephalomyelitis

We wished to study how infections might trigger relapses of autoimmune diseases such as multiple sclerosis (MS) and encephalomyelitis (EAE). We hypothesized that immune responses to heat shock proteins (hsp) induced by an infection could modulate responses to autoantigens. We induced extra-neuraxial inflammation in SJL mice housed either in specific-pathogen free (SPF) or conventional facilities. Mice in conventional housing are continuously exposed to large numbers of infectious agents. Spleen cell proliferative responses to human HSP60 and bacterial HSP65 were measured as were numbers of cells secreting IFN-gamma or IL-5. Proliferative responses to HSP60 were increased in conventionally housed mice compared to SPF mice and this was associated with skewing of secreted cytokines toward a Th2 pattern. Skewing toward a Th1 pattern was noted in SPF mice. Acute and relapsing EAE was induced in both groups of mice. Acute EAE was, in general, equivalent in all groups. However, SPF mice had more severe relapses than did conventionally housed animals and these differences were amplified by extra-neuraxial inflammation. Immunocytochemical analyses of brains from mice with relapsing EAE showed that increased numbers of brain gamma/delta cells were associated with disease remission. Our data suggest that frequent exposure to infectious agents leads to a relative Th2 skewing of immune responses to hsp and that this is associated with milder, less frequent relapses of EAE. They also support the concept that immune responses to hsp are of potential importance in exacerbating and perpetuating organ-restricted autoimmune diseases.

The neuregulin, glial growth factor 2, diminishes autoimmune demyelination and enhances remyelination in a chronic relapsing model for multiple sclerosis

Glial growth factor 2 (GGF2) is a neuronal signal that promotes the proliferation and survival of the oligodendrocyte, the myelinating cell of the central nervous system (CNS). The present study examined whether recombinant human GGF2 (rhGGF2) could effect clinical recovery and repair to damaged myelin in chronic relapsing experimental autoimmune encephalomyelitis (EAE) in the mouse, a major animal model for the human demyelinating disease, multiple sclerosis. Mice with EAE were treated with rhGGF2 during both the acute and relapsing phases. Clinically, GGF2 treatment delayed signs, decreased severity, and resulted in statistically significant reductions in relapse rate. rhGGF2-treated groups displayed CNS lesions with more remyelination than in controls. This correlated with increased mRNA expression of myelin basic protein exon 2, a marker for remyelination, and with an increase in the CNS of the regulatory cytokine, interleukin 10, at both the RNA and protein levels. Thus, a beneficial effect of a neurotrophic growth factor has been demonstrated on the clinical, pathologic, and molecular manifestations of autoimmune demyelination, an effect that was associated with increased expression of a T helper 2 cytokine. rhGGF2 treatment may represent a novel approach to the treatment of multiple sclerosis.

Cell death during autoimmune demyelination: effector but not target cells are eliminated by apoptosis

The Fas and FasL apoptotic pathway was investigated by protein immunohistochemistry, flow cytometry, and reverse transcriptase-PCR analysis to assess whether it is involved in the elimination of target and/or effector cells from the central nervous system (CNS) during adoptively transferred chronic relapsing experimental autoimmune encephalomyelitis (EAE), a model for multiple sclerosis. In addition to Fas and FasL, we studied Bax, an intracellular protein of the apoptotic cascade, the Bax antagonist and anti-apoptotic molecule Bcl-2, and DNA fragmentation, the final step in the apoptotic pathway. Infiltrating CD4+ T cells and parenchymal microglia expressed Fas, FasL, and Bax, and about half of these cells showed DNA fragmentation, a combination indicative of ongoing apoptosis. Using flow cytometry and reverse transcriptase-PCR, a positive correlation was seen between disease activity and up-regulation of the Fas system; in fact, Fas and FasL were expressed at low levels at the onset of EAE and increased at the height of disease to involve about one-third of all infiltrating lymphocytes. In the normal CNS, Fas immunoreactivity was constitutively present at low levels on oligodendrocytes and was up-regulated in the CNS during the course of EAE. However, oligodendrocytes showed no Bax reactivity or DNA fragmentation and expressed high levels of Bcl-2, as did the majority of infiltrating CD3+ cells, a pattern inconsistent with apoptosis. Thus, while molecules of the apoptotic cascade are well represented in the CNS during EAE, their expression correlates with elimination of infiltrating cells and microglia, not the myelinating cell, the oligodendrocyte.

Cell death during autoimmune demyelination: effector but not target cells are eliminated by apoptosis

The Fas and FasL apoptotic pathway was investigated by protein immunohistochemistry, flow cytometry, and reverse transcriptase-PCR analysis to assess whether it is involved in the elimination of target and/or effector cells from the central nervous system (CNS) during adoptively transferred chronic relapsing experimental autoimmune encephalomyelitis (EAE), a model for multiple sclerosis. In addition to Fas and FasL, we studied Bax, an intracellular protein of the apoptotic cascade, the Bax antagonist and anti-apoptotic molecule Bcl-2, and DNA fragmentation, the final step in the apoptotic pathway. Infiltrating CD4+ T cells and parenchymal microglia expressed Fas, FasL, and Bax, and about half of these cells showed DNA fragmentation, a combination indicative of ongoing apoptosis. Using flow cytometry and reverse transcriptase-PCR, a positive correlation was seen between disease activity and up-regulation of the Fas system; in fact, Fas and FasL were expressed at low levels at the onset of EAE and increased at the height of disease to involve about one-third of all infiltrating lymphocytes. In the normal CNS, Fas immunoreactivity was constitutively present at low levels on oligodendrocytes and was up-regulated in the CNS during the course of EAE. However, oligodendrocytes showed no Bax reactivity or DNA fragmentation and expressed high levels of Bcl-2, as did the majority of infiltrating CD3+ cells, a pattern inconsistent with apoptosis. Thus, while molecules of the apoptotic cascade are well represented in the CNS during EAE, their expression correlates with elimination of infiltrating cells and microglia, not the myelinating cell, the oligodendrocyte.

IL-10 fails to abrogate experimental autoimmune encephalomyelitis

Mice adoptively-sensitized to develop chronic relapsing experimental autoimmune encephalomyelitis (EAE), a model for the human demyelinating condition, multiple sclerosis (MS), were given injections of recombinant human IL-10 at various timepoints post-sensitization in an attempt to abrogate disease development. IL-10 is a Th2 immunomodulatory cytokine with known down-regulatory effects upon Th1 responses and macrophages. Contrary to a previous report on EAE and the predicted outcome, after repeated experiments, IL-10 was found to elicit a worsening or no effect upon EAE in the mouse. Animals were studied clinically, histopathologically and immunocytochemically. On no occasion was disease ameliorated by IL-10. Pretreatment with IL-10 of lymph node cells used to transfer EAE had no effect upon disease outcome, indicating that the cells were already committed effectors. Administration of anti-IL-10 monoclonal antibody before onset of signs had no effect when given early post-sensitization and caused marked worsening when given immediately before onset of signs. In the context of this autoimmune demyelinating model, these results suggest that IL-10 alone is insufficient to reverse the effector response and indeed may serve to enhance the cascade of events in EAE.

A pathogenic role for gamma delta T cells in relapsing-remitting experimental allergic encephalomyelitis in the SJL mouse

Previous studies have detected gamma delta T cells in multiple sclerosis and experimental allergic encephalomyelitis (EAE) lesions but their role remains obscure. In the present study, we assessed gamma delta T cell dynamics and distribution in spleen and central nervous system (CNS) from mice with relapsing-remitting EAE, and studied the effect of depleting these cells on clinical and pathologic expression of disease using the mAb GL3. By immunohistochemistry and FACS analysis, striking disease-related changes were observed in the gamma delta T cell population in the CNS. FACS analysis showed that while gamma delta T cells remained low in the spleen (approximately 2% total CD3+ T cells) at all stages, in the CNS they increased to approximately 12% at the height of the acute attack, fell to approximately 5% during the recovery phase, but rose again to approximately 12% during the chronic phase. In animals in which gamma delta T cells were depleted immediately before the onset of acute disease, or during the chronic stage, a striking and significant reduction in the severity of the clinical signs was observed that was associated with a decrease in the percentage of CD3+/gamma delta T cells in the CNS. In depleted animals a statistically significant reduction in inflammation and demyelination was noted during the acute stage, but only marginal effects on these disease parameters were found in the chronic phase. Taken together, the data support the conclusion that gamma delta T cells play an important role in the pathogenesis of EAE in mice during both acute and chronic/progressive phases of the disease process.

A pathogenic role for gamma delta T cells in relapsing-remitting experimental allergic encephalomyelitis in the SJL mouse

Previous studies have detected gamma delta T cells in multiple sclerosis and experimental allergic encephalomyelitis (EAE) lesions but their role remains obscure. In the present study, we assessed gamma delta T cell dynamics and distribution in spleen and central nervous system (CNS) from mice with relapsing-remitting EAE, and studied the effect of depleting these cells on clinical and pathologic expression of disease using the mAb GL3. By immunohistochemistry and FACS analysis, striking disease-related changes were observed in the gamma delta T cell population in the CNS. FACS analysis showed that while gamma delta T cells remained low in the spleen (approximately 2% total CD3+ T cells) at all stages, in the CNS they increased to approximately 12% at the height of the acute attack, fell to approximately 5% during the recovery phase, but rose again to approximately 12% during the chronic phase. In animals in which gamma delta T cells were depleted immediately before the onset of acute disease, or during the chronic stage, a striking and significant reduction in the severity of the clinical signs was observed that was associated with a decrease in the percentage of CD3+/gamma delta T cells in the CNS. In depleted animals a statistically significant reduction in inflammation and demyelination was noted during the acute stage, but only marginal effects on these disease parameters were found in the chronic phase. Taken together, the data support the conclusion that gamma delta T cells play an important role in the pathogenesis of EAE in mice during both acute and chronic/progressive phases of the disease process.