Immunology of lymphatic filariasis

The immune responses to filarial parasites encompass a complex network of innate and adaptive cells whose interaction with the parasite underlies a spectrum of clinical manifestations. The predominant immunological feature of lymphatic filariasis is an antigen-specific Th2 response and an expansion of IL-10 producing CD4(+) T cells that is accompanied by a muted Th1 response. This antigen-specific T-cell hyporesponsiveness appears to be crucial for the maintenance of the sustained, long-standing infection often with high parasite densities. While the correlates of protective immunity to lymphatic filariasis are still incompletely understood, primarily due to the lack of suitable animal models to study susceptibility, it is clear that T cells and to a certain extent B cells are required for protective immunity. Host immune responses, especially CD4(+) T-cell responses clearly play a role in mediating pathological manifestations of LF, including lymphedema, hydrocele and elephantiasis. The main underlying defect in the development of clinical pathology appears to be a failure to induce T-cell hyporesponsiveness in the face of antigenic stimulation. Finally, another intriguing feature of filarial infections is their propensity to induce bystander effects on a variety of immune responses, including responses to vaccinations, allergens and to other infectious agents. The complexity of the immune response to filarial infection therefore provides an important gateway to understanding the regulation of immune responses to chronic infections, in general.

Cytotoxicity of TiO2 nanoparticles towards freshwater sediment microorganisms at low exposure concentrations

There is a persistent need to assess the effects of TiO2 nanoparticles on the aquatic ecosystem owing to their increasing usage in consumer products and risk of environmental release. The current study is focused on TiO2 nanoparticle-induced acute toxicity at sub-ppm level (≤1ppm) on the three different freshwater sediment bacterial isolates and their consortium under two different irradiation (visible light and dark) conditions. The consortium of the bacterial isolates was found to be less affected by the exposure to the nanoparticles compared to the individual cells. The oxidative stress contributed considerably towards the cytotoxicity under both light and dark conditions. A statistically significant increase in membrane permeability was noted under the dark conditions as compared to the light conditions. The optical and fluorescence microscopic images showed aggregation and chain formation of the bacterial cells, when exposed to the nanoparticles. The electron microscopic (SEM, TEM) observations suggested considerable damage of cells and bio-uptake of nanoparticles. The exopolysaccrides (EPS) production and biofilm formation were noted to increase in the presence of the nanoparticles, and expression of the key genes involved in biofilm formation was studied by RT-PCR.

Tolerance and toxicity of neoadjuvant docetaxel, cisplatin and 5 fluorouracil regimen in technically unresectable oral cancer in resource limited rural based tertiary cancer center

BACKGROUND

Recent studies indicate neoadjuvant chemotherapy (NACT) can result in R0 resection in a substantial proportion of patients with technically unresectable oral cavity cancers. However, data regarding the efficacy and safety of docetaxel, cisplatin and 5 fluorouracil (TPF) NACT in our setting is lacking. The present audit was proposed to evaluate the toxicities encountered during administration of this regimen. It was hypothesized that TPF NACT would be considered feasible for routine administration if an average relative dose intensity (ARDI) of ≥0.90 or more in at least 70% of the patients.

MATERIALS AND METHODS

Technically unresectable oral cancers with Eastern Cooperative Oncology Group PS 0-2, with biopsy proven squamous cell carcinoma underwent two cycles of NACT with TPF regimen. Toxicity and response rates were noted following the CTCAE 4.03 and RECIST criteria. Descriptive analysis of completion rates (completing 2 cycles of planned chemotherapy with ARDI of 0.85 or more), reason for delay, toxicity, and response are presented.

RESULTS

The NACT was completed by all patients. The number of subjects who completed all planned cycles of chemotherapy are with the ARDI of the delivered chemotherapy been equal to or >0.85 was 11 (91.67%). All toxicity inclusive Grade 3-5 toxicity was seen in 11 patients (91.67%). The response rate of chemotherapy was 83.33%. There were three complete response, seven partial response, and two stable disease seen post NACT in this study.

CONCLUSION

Docetaxel, cisplatin and 5 fluorouracil regimen can be routinely administered at our center with the supportive care methods and precautionary methods used in our study.

Investigations on luminescence performance of Sm3+ ions activated in multi-component fluoro-phosphate glasses

Different metal oxide based fluoro-phosphate glasses doped with Sm(3+) ions are investigated using XRD, SEM with EDS, FTIR, Raman spectra, optical absorption and photo-luminescence techniques. These glass matrices have been prepared by conventional melt quenching technique. The glassy nature of the present glass matrices are confirmed by XRD profiles and SEM photographs. The composition of the glasses is checked by EDS. Based on FTIR and Raman spectra, the authors have analyzed functional groups that are present in the glass matrices. Judd-Ofelt intensity parameters, Ωλ (λ=2,4,6) have been evaluated from absorption spectra. Radiative parameters such as radiative transition probabilities (AR), radiative lifetimes (τR), integrated absorption cross sections (Σ) and branching ratios (βR) are calculated using Judd-Ofelt intensity parameters. From the photoluminescence spectra, experimental branching ratios (βexp) and stimulated emission cross-sections (σP) for all the observed emission transitions are calculated. To investigate luminescence potentiality of (4)G5/2→(6)H7/2 emission level of Sm(3+) doped different fluorophosphate glasses, experimental radiative lifetimes (τexp) are obtained from decay curve analysis for all glass matrices. Finally, these observed results are discussed and compared with the literature data.

Terminal complement inhibitor eculizumab in atypical hemolytic-uremic syndrome

BACKGROUND

Atypical hemolytic-uremic syndrome is a genetic, life-threatening, chronic disease of complement-mediated thrombotic microangiopathy. Plasma exchange or infusion may transiently maintain normal levels of hematologic measures but does not treat the underlying systemic disease.

METHODS

We conducted two prospective phase 2 trials in which patients with atypical hemolytic-uremic syndrome who were 12 years of age or older received eculizumab for 26 weeks and during long-term extension phases. Patients with low platelet counts and renal damage (in trial 1) and those with renal damage but no decrease in the platelet count of more than 25% for at least 8 weeks during plasma exchange or infusion (in trial 2) were recruited. The primary end points included a change in the platelet count (in trial 1) and thrombotic microangiopathy event-free status (no decrease in the platelet count of >25%, no plasma exchange or infusion, and no initiation of dialysis) (in trial 2).

RESULTS

A total of 37 patients (17 in trial 1 and 20 in trial 2) received eculizumab for a median of 64 and 62 weeks, respectively. Eculizumab resulted in increases in the platelet count; in trial 1, the mean increase in the count from baseline to week 26 was 73×10(9) per liter (P<0.001). In trial 2, 80% of the patients had thrombotic microangiopathy event-free status. Eculizumab was associated with significant improvement in all secondary end points, with continuous, time-dependent increases in the estimated glomerular filtration rate (GFR). In trial 1, dialysis was discontinued in 4 of 5 patients. Earlier intervention with eculizumab was associated with significantly greater improvement in the estimated GFR. Eculizumab was also associated with improvement in health-related quality of life. No cumulative toxicity of therapy or serious infection-related adverse events, including meningococcal infections, were observed through the extension period.

CONCLUSIONS

Eculizumab inhibited complement-mediated thrombotic microangiopathy and was associated with significant time-dependent improvement in renal function in patients with atypical hemolytic-uremic syndrome. (Funded by Alexion Pharmaceuticals; C08-002 ClinicalTrials.gov numbers, NCT00844545 [adults] and NCT00844844 [adolescents]; C08-003 ClinicalTrials.gov numbers, NCT00838513 [adults] and NCT00844428 [adolescents]).

Tissue is issue: Not all masses are tumors

Background:

Tuberculosis can disguise itself in any form. Endobronchial tuberculosis usually presents in young adults. Endobronchial tumor-like presentation of tuberculosis (EBTB) is very rare and often mistaken as a malignancy. Diagnosis is usually delayed, as clinical and radiological features are non-specific. Direct implantation of tubercle bacilli into the bronchus, or an contiguous spread, leads to EBTB. Bronchoscopic biopsy and culture are the best modality for diagnosis.

Care Reports:

Clinical and radiological presentations of all cases were similar and one of them had rib erosion on bone scan. All cases were proven to be tuberculosis by histopathology and culturing mycobacterium tuberculosis. All of them are diagnosed as endobronchial tuberculosis, either histopathology or by culture that grew mycobacterium tuberculosis, and were successfully treated with anti-tuberculous treatment alone, without residual scarring.

Conclusions:

Tuberculosis should be considered in the differential diagnosis of endobronchial mass lesions in the appropriate clinical setting since this is an uncommon presentation for which invasive procedures are needed to establish the diagnosis. Initially, it was mistaken as a malignancy and there was delay in diagnosis and initiation of treatment. Prompt treatment is crucial to avert residual bronchostenosis.

Recombinant Wolbachia surface protein (WSP)-induced T cell responses in Wuchereria bancrofti infections

Human lymphatic filariasis is a debilitating parasitic disease characterized by downregulation of the host's immune response in asymptomatic carriers along with profound hyperreactivity in chronic patients apart from putatively immune endemic normals. The endosymbiont Wolbachia, a bacterium of filarial nematodes has received much attention as possible chemotherapeutic target and its involvement in disease pathogenesis. The role of recombinant Wolbachia surface protein (rWSP), one of the most abundantly expressed proteins of the endosymbiont, in modulating cell-mediated immune responses in patients harboring Wuchereria bancrofti infections was evaluated in the current study. rWSP-induced lymphoproliferation with peripheral blood mononuclear cells suggested an impaired proliferative response in asymptomatic microfilaremic (MF) and symptomatic chronic pathology (CP) patients compared to endemic normals (EN). This was further supported by a significantly diminished expression of CD69 along with elevated levels of CD127 and CD62L in filarial patients (MF and CP) compared to EN. Further, rWSP induced the expression of regulatory T cell markers CTLA-4 and CD25 along with suppressor cytokines IL-10 and TGF-β in MF and CP patients compared to EN. However, the rWSP-stimulated expression of IFN-γ was diminished significantly in filarial patients compared to endemic normals. Thus, these findings suggest that WSP may also contribute to the suppression of immune responses seen in filarial patients.

Unusual clinicoradiographic presentation of a lateral periodontal cyst

The lateral periodontal cyst is an uncommon, but well-recognized type of developmental odontogenic cyst. Lateral periodontal cysts are defined as non-keratinized and non-inflammatory developmental cysts located adjacent or lateral to the root of a vital tooth. It is a relatively uncommon lesion found mostly in adults (5th to 7th decades) and it is rare in young people under 30 years of age. A common site of occurrence is the mandibular premolar region. It does not have a predilection for any race or sex. Histopathologically, the lateral periodontal cyst lining is characterized by a thin cuboidal to stratified squamous non-keratinizing epithelium, ranging from one to five cell layers and presence of one or more epithelial thickenings or plaques.The purpose of this article is to report a case of interradicular radiolucent cystic lesion in a thirteen-year-old girl, located in a rare site of the maxillary premolar area, mimicking clinical and radiographical features of a residual cyst, but histopathologically proven to be a lateral periodontal cyst.

Characterization and enhanced production of prodigiosin from the spoiled coconut

Many bacterial secondary products are bioactive substances that play an important role in biotechnology and pharmacology (e.g., as antibiotics or antitumor agents). Over the past few years interest in prodigiosin has been increased due to its promising anti-cancer activity. Prodigiosin is also of potential clinical interest because it is reported to have anti-fungal, anti-bacterial, anti-protozoal/anti-malarial, and immunosuppressive activity. Thus there is a need to develop a high-throughput and cost-effective bioprocess for the production of prodigiosin. In the present study, Serratia rubidaea was isolated from colored portion of a spoiled coconut and further it was authenticated by MTCC, India. The various parameters like temperature, pH, salt concentration, and precursors were optimized for the production of prodigiosin. We now report that the pigment production was higher in our isolated strain than S. marcescens. It was observed that prodigiosin binds with plastic, paper, and fibers and thus in near future, it can also be used as a natural dye.

Immune responses to recombinant Brugia malayi pepsin inhibitor homolog (Bm-33) in patients with human lymphatic filariaisis

Immune responses to recombinant Brugia malayi pepsin inhibitor homolog (rBm-33) were investigated in patients with human lymphatic filariasis (microfilaremics (MF) and chronic pathology (CP)) along with endemic normals (EN). Flow cytometric analysis (24 h) revealed CD4(+) T cell activation in patients (MF and CP) compared to normals (EN), with increased expression of CD69 and diminished levels of CD62L and CD127. This was associated with an elevated expression of CD154 but not CD28 and CTLA4 in CP patients. However, Bm-33-induced cytokine expression profile (IL-1β, IL-12, IL-8, IFN-γ, IL-10 and TGF-β) did not exhibit any significant difference between normals and patients at the same time point. Although CD4(+) T cell activation was observed initially in filarial patients (24 h), lymphoproliferation studies (96 h) suggested diminished proliferation compared to normals, indicating functional inactivation in the former upon prolonged antigen exposure. This indicates that rBm-33 induces an early T cell activation in MF and CP patients followed by a decreased lymphoproliferation that might contribute to immune suppression in these individuals.

Depletion of serum zinc in ischemic stroke patients

The pathogenesis of a number of diseases like cardiovascular diseases, cancer and neurological disorders, has been associated with changes in the balance of certain trace elements. In this study we aimed at investigating the levels of trace elements like calcium, copper, iron and zinc, in ischemic stroke patients in comparison with healthy controls. Serum samples were collected from 256 ischemic stroke patients and 180 healthy, age and sex matched controls. Trace element levels were detected using commercially available kits and an Auto-Analyzer (ChemWell 2910, Awareness Technology, US). The concentrations of calcium, copper and iron were not significantly different in patients when compared to healthy controls. The concentration of zinc was significantly lower in stroke patients (P = 0.001) as compared to normal subjects. To conclude, patients with acute ischemic stroke have reduced levels of serum zinc. Zinc may represent an independent risk factor for stroke and therefore a possible target for prevention. Additional studies are needed to further examine the role of zinc in the pathogenesis of stroke.