Immunotherapeutic relief from persistent infections and amyloid disorders

New advances in CNS immunity against viral infection

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Advances in CNS immunity and anatomy bridge the CNS and the peripheral immune system.

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Region-specific antiviral responses alter BBB permeability during viral invasion.

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CNS barriers have anatomical specializations with tailored defenses against pathogens.

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Immunocytotherapies for persistent CNS infections can promote non-cytopathic viral clearance.

The central nervous system (CNS) is an immunologically specialized organ where restrictive barrier structures protect the parenchyma from inflammation and infection. This protection is important in preventing damage to non-renewable resident cell populations, such as neurons, responsible for functions ranging from executive to autonomic. Despite these barriers, the CNS can be infected through several entry portals, giving rise to meningitis and encephalitis. Following infection, resident cells recruit peripherally derived immune cells to sites of viral infection. In this review, we discuss recent advances in immune recruitment and entry at barrier structures as well as current immunotherapeutic strategies for the treatment of persistent viral infections.

How citation distortions create unfounded authority: analysis of a citation network

OBJECTIVE

To understand belief in a specific scientific claim by studying the pattern of citations among papers stating it.

DESIGN

A complete citation network was constructed from all PubMed indexed English literature papers addressing the belief that beta amyloid, a protein accumulated in the brain in Alzheimer's disease, is produced by and injures skeletal muscle of patients with inclusion body myositis. Social network theory and graph theory were used to analyse this network.

MAIN OUTCOME MEASURES

Citation bias, amplification, and invention, and their effects on determining authority.

RESULTS

The network contained 242 papers and 675 citations addressing the belief, with 220,553 citation paths supporting it. Unfounded authority was established by citation bias against papers that refuted or weakened the belief; amplification, the marked expansion of the belief system by papers presenting no data addressing it; and forms of invention such as the conversion of hypothesis into fact through citation alone. Extension of this network into text within grants funded by the National Institutes of Health and obtained through the Freedom of Information Act showed the same phenomena present and sometimes used to justify requests for funding.

CONCLUSION

Citation is both an impartial scholarly method and a powerful form of social communication. Through distortions in its social use that include bias, amplification, and invention, citation can be used to generate information cascades resulting in unfounded authority of claims. Construction and analysis of a claim specific citation network may clarify the nature of a published belief system and expose distorted methods of social citation.

Treatment strategies for amyloid A amyloidosis

BACKGROUND

Amyloid A (AA) amyloidosis is a serious complication of a wide range of chronic inflammatory, infectious and neoplastic diseases. A longstanding overproduction of the liver-synthesised cytokine-induced acute phase serum amyloid A (SAA) protein is a key event in the pathogenetic cascade leading to the deposition of AA amyloid in tissues and organs.

OBJECTIVE

The aim of the study was to critically review treatment strategies in AA amyloidosis.

METHODS

A systematic literature review was conducted based on PubMed (January 1980 - April 2008) and selected conference abstracts.

RESULTS/CONCLUSIONS

The current strategy for the treatment of AA amyloidosis is firmly based on the knowledge of the underlying pathogenetic mechanism and aims at reducing the amyloid precursor (SAA) load by intensive anti-inflammatory/immunosuppressive therapy and, in selected instances, anticytokine (TNF-alpha, IL-1beta or IL-6 blockade) therapy, or, when applicable, the eradication of an existing infectious focus (surgery, antimicrobial drugs). Emerging strategies focus on the dissolution of the amyloid deposits using small molecules that either interact with the glycosaminoglycans or the fibril component of the deposits, or deplete amyloid P component.

Downregulation of an astrocyte-derived inflammatory protein, S100B, reduces vascular inflammatory responses in brains persistently infected with Borna disease virus

Borna disease virus (BDV) is a neurotropic virus that causes a persistent infection in the central nervous system (CNS) of many vertebrate species. Although a severe reactive gliosis is observed in experimentally BDV-infected rat brains, little is known about the glial reactions contributing to the viral persistence and immune modulation in the CNS. In this regard, we examined the expression of an astrocyte-derived factor, S100B, in the brains of Lewis rats persistently infected with BDV. S100B is a Ca(2+)-binding protein produced mainly by astrocytes. A prominent role of this protein appears to be the promotion of vascular inflammatory responses through interaction with the receptor for advanced glycation end products (RAGE). Here we show that the expression of S100B is significantly reduced in BDV-infected brains despite severe astrocytosis with increased glial fibrillary acidic protein immunoreactivity. Interestingly, no upregulation of the expression of S100B, or RAGE, was observed in the persistently infected brains even when incited with several inflammatory stimuli, including lipopolysaccharide. In addition, expression of the vascular cell adhesion molecule 1 (VCAM-1), as well as the infiltration of encephalitogenic T cells, was significantly reduced in persistently infected brains in which an experimental autoimmune encephalomyelitis was induced by immunization with myelin-basic protein. Furthermore, we demonstrated that the continuous activation of S100B in the brain may be necessary for the progression of vascular immune responses in neonatally infected rat brains. Our results suggested that BDV infection may impair astrocyte functions via a downregulation of S100B expression, leading to the maintenance of a persistent infection.