CAR T-cell therapy for central nervous system lymphomas: blood and cerebrospinal fluid biology, and outcomes

Not available.

MAIT cells altered phenotype and cytotoxicity in lupus patients are linked to renal disease severity and outcome

Introduction

Systemic lupus erythematosus (SLE) is an autoimmune disease in which circulating immune complexes can cause different types of glomerulonephritis, according to immune deposits and to the type of glomerular cell injury. Proliferative lesions represent the most severe form of lupus nephritis (LN) and often lead to kidney failure and death. Mucosal-associated invariant T (MAIT) cells are a subset of innate-like T cells that recognize microbial-derived ligands from the riboflavin synthesis pathway. Although abundant in peripheral blood, MAIT cells are enriched in mucosal and inflamed tissues. While previous studies have reported concordant results concerning lower MAIT cell frequencies in the blood of SLE patients, no information is known about MAIT cell function and LN severity and outcome.

Methods

In the current study, we analyzed the baseline phenotype and function of peripheral blood MAIT cells by flow cytometry in 26 patients with LN and in a control group of 16 healthy individuals.

Results

We observe that MAIT cell frequencies are markedly reduced in blood of LN patients. MAIT cells from patients have an altered phenotype in terms of migration, proliferation and differentiation markers, notably in most severe forms of LN. Frequencies of PMA/ionomycin stimulated MAIT cells secreting effector molecules, such as proinflammatory IL-17 and cytotoxic protein granzyme B, are higher in LN patients. Patients undergoing a complete renal remission after immunosuppressive therapy had higher MAIT cell frequency, lower expression of proliferation marker Ki-67 and granzyme B (GzB) at inclusion. Remarkably, GzB production defines a predictive model for complete remission.

Discussion

We report here that blood MAIT cells display proinflammatory and cytotoxic function in severe lupus nephritis which may play a pathogenesis role, but without association with systemic lupus activity. Finally, low cytotoxic profile of MAIT cells may represent a promising prognostic factor of lupus nephritis remission one year after induction therapy.

Identification of natural killer markers associated with fatal outcome in COVID-19 patients

Introduction

Increasing evidence has shown that coronavirus disease 19 (COVID-19) severity is driven by a dysregulated immunological response. Previous studies have demonstrated that natural killer (NK) cell dysfunction underpins severe illness in COVID-19 patients, but have lacked an in-depth analysis of NK cell markers as a driver of death in the most critically ill patients.

Methods

We enrolled 50 non-vaccinated hospitalized patients infected with the initial virus or the alpha variant of SARS-CoV-2 with moderate or severe illness, to evaluate phenotypic and functional features of NK cells.

Results

Here, we show that, consistent with previous studies, evolution NK cells from COVID-19 patients are more activated, with the decreased activation of natural cytotoxicity receptors and impaired cytotoxicity and IFN-γ production, in association with disease regardless of the SARS-CoV-2 strain. Fatality was observed in 6 of 17 patients with severe disease; NK cells from all of these patients displayed a peculiar phenotype of an activated memory-like phenotype associated with massive TNF-α production.

Discussion

These data suggest that fatal COVID-19 infection is driven by an uncoordinated inflammatory response in part mediated by a specific subset of activated NK cells.

Anti-PD-1 immune-related adverse events are associated with high therapeutic antibody fixation on T cells

Immune checkpoint inhibitors (ICI) widely improved the treatment of solid and hematologic malignancies. Yet, a remarkable proportion of patients receiving ICI develop immune related adverse events (irAEs) which are difficult to define as treatment-related. This underlines the need to develop a biomarker to guide irAE diagnosis. We developed a novel flow cytometry assay combining measurement of anti-PD-1 (programmed cell death protein-1) occupancy and evaluation of remaining PD-1 receptor availability with anti-IgG4 PE and anti-PD-1 BV421. We prospectively collected blood and biological fluids samples from patients treated by IgG4 anti-PD-1 therapy (nivolumab or pembrolizumab), with (n=18) or without (n=12) current irAE. We analyzed PD-1+ and IgG4+ staining pattern and MFI values of these parameters on CD4 and CD8 T cells, and IgG4+/PD-1+ MFI ratios are calculated. A higher mean fluorescence intensity IgG4+/PD-1+ ratio was measured on peripheral CD4+ T cells of irAE cases, when compared to controls (p=0.003). ICI-related toxicity is therefore associated with increased therapeutic antibody occupancy of PD-1 receptors on CD4+ T cells. Furthermore, in one case of ICI-related pneumonitis, binding of therapeutic antibody was stronger on lung CD4+ T cell than in blood. In another case of ICI-related encephalitis, the PD-1 receptor occupancy was total on CSF CD4 T cells, but only partial on peripherical CD4 T cells. Our results suggest that flow cytometry monitoring of ICI occupancy can be used in patients treated with monoclonal ICI to guide irAE diagnosis.

Psychosocial interventions for cardiac surgery patients: continuity at clinical stages

Introduction

More often, cardiac surgery patients (CSP) receive systematic psychological aid after surgery. However, their need for psychosocial interventions in the perioperative period is underestimated.

Objectives

The goal is to determine the stages of psychosocial interventions for CSP that could cover the whole period of their treatment and rehabilitation.

Methods

Analysis of scientific papers and practical experience gained in cardiologic clinic allowed dividing the system of psychosocial interventions for cardiac surgery patients into periods in accordance with actual stages of medical aid for CSPs.

Results

According to the principles of personalized approach, we determined six consecutive semantically different stages of psychosocial interventions: out-of-hospital pre-surgery, in-hospital pre-surgery, early post-surgery, in-hospital post-surgery, post-surgery rehabilitation, and out-of-hospital rehabilitation. They have different duration and cover the whole period of treatment and rehabilitation of CSPs beginning with the moment of indication to surgery up to the complete rehabilitation and full adaptation to their post-surgery somatic condition. Each stage has its own goals, main objectives and expectations. Duration of the stages is conditional and can change depending on the nature of every clinical situation.

Conclusions

Determination of clinical stages in the process of psychosocial interventions for CSPs gives ground for selecting optimal psychological methods and techniques for each stage and sets exact goals, achievement of which becomes possible only through a properly organised work of an interdisciplinary team of specialists.

Disclosure

No significant relationships.

Status and analysis of trends in the metformin -based drug development: formation of the logistic system of scientific research

The aim of the work is analysis of the current state and trends in the metformin-based drug development with the subsequent formation of the logistics system of scientific research. Materials and methods. Studies were conducted using databases on the Internet (2015-2022): PubMed; U.S. Food and Drug Administration, European Medicines Agency, the State Expert Center of the Ministry of Health of Ukraine, scientific and metric databases - Scopus, Cochrane Database, US Patent Office. It has used retrospective, logical, graphic research methods, content analysis, modelling. Results. The model of the logistic system of metformin scientific research has developed. It represents the set of elements that are interconnected through information communication, its composition and features, which are associated with the pharmacological action of metformin, are determined. Logistic system of metformin scientific research allows: to demonstrate the uniqueness of the drug, to reveal its potential and new opportunities for medical use, prospects for the development of new types of dosage forms and new combined drugs; to identify the threat of patent infringement, to identify opportunities for establishing partnerships; to present scientific products in the form of a drug on the pharmaceutical market, optimizing the research time, reducing the development stages due to the available information and documentation, ensuring the synchronization of innovative information flows; to optimize the total costs of scientific research and receive at the expense of the specified profit. Logistic system of metformin scientific research is recommended for implementation in scientific organizations and pharmaceutical companies that perform R&D to achieve concentration of information search in solving logistics problems in the field of creating medicines based on metformin. Conclusions. Thus, the management of scientific research in pharmacy using the logistic approach ensures the time reduction of the medicine to entry into the market, reduces the cost of its creation, prevents duplication of research, and promotes optimization of solutions. The analysis revealed that the creation of medicines based on metformin should be aimed at the search and development of combined sugar-reducing drugs with mutually complementary mechanisms of action

Memory CD4+ T-Cell Lymphocytic Angiopathy in Fatal Forms of COVID-19 Pulmonary Infection

The immunopathological pulmonary mechanisms leading to Coronavirus Disease (COVID-19)-related death in adults remain poorly understood. Bronchoalveolar lavage (BAL) and peripheral blood sampling were performed in 74 steroid and non-steroid-treated intensive care unit (ICU) patients (23-75 years; 44 survivors). Peripheral effector SARS-CoV-2-specific T cells were detected in 34/58 cases, mainly directed against the S1 portion of the spike protein. The BAL lymphocytosis consisted of T cells, while the mean CD4/CD8 ratio was 1.80 in non-steroid- treated patients and 1.14 in steroid-treated patients. Moreover, strong BAL SARS-CoV-2 specific T-cell responses were detected in 4/4 surviving and 3/3 non-surviving patients. Serum IFN-γ and IL-6 levels were decreased in steroid-treated patients when compared to non-steroid treated patients. In the lung samples from 3 (1 non-ICU and 2 ICU) additional deceased cases, a lymphocytic memory CD4 T-cell angiopathy colocalizing with SARS-CoV-2 was also observed. Taken together, these data show that disease severity occurs despite strong antiviral CD4 T cell-specific responses migrating to the lung, which could suggest a pathogenic role for perivascular memory CD4 T cells upon fatal COVID-19 pneumonia.

Beyond-mean-field calculations of allowed and first-forbidden β− decays of r-process waiting-point nuclei

β-decay rates of neutron-rich nuclei, in particular those located at neutron shell closures, play a central role in simulations of the heavy-element nucleosynthesis and resulting abundance distributions. We present β-decay half-lives of even-even N = 82 and N = 126 r-process waiting-point nuclei calculated in the approach based on relativistic quasiparticle random phase approximation with quasiparticle-vibration coupling. The calculations include both allowed and first-forbidden transitions. In the N = 82 chain, the quasiparticlevibration coupling has an important impact close to stability, as it increases the contribution of Gamow-Teller modes and improves the agreement with the available data. In the N = 126 chain, we find the decay to proceed dominantly via first-forbidden transitions, even when the coupling to vibrations is included.

The structure of depressive manifestations in preoperative cardiac surgery patients

Introduction

It is common knowledge that depressive disorders are prevalent in cardiac patients. The fact of a prospective heart surgery can have a negative effect on depressive manifestations in cardiac patients.

Objectives

To describe representation and structure of depression in preoperative cardiac surgery patients and its correlation with the patients’ personal time perspective

Methods

We used the Beck Depression Inventory to estimate the level and structure of depression in 60 cardiac surgery patients of both sexes and the Zimbardo Time Perspective Inventory to identify the patients’ personal time perspective.

Results

We revealed depression of various manifestations in 53.4% of preoperative cardiac patients; 3.3% of them had severe depression, 11.7% – moderate depression, 8.3% – mild depression, 30.0% – minimal depression. The patients’ average level of depression was certainly higher than the standard one (t=3.295; р=.000). According to degree, the structure of depressive manifestations included asthenia, irritability, sleeping disorders, low sex drive, weight loss, pessimism, tearfulness, difficulty working, and difficulty taking decision. Two patients showed suicidal thoughts. We revealed a positive correlation between the depression level and a Negative-Past time perspective (r=.39) and a negative correlation with the Positive Past time perspective (r=-.27).

Conclusions

We identified depressive manifestations in every second preoperative cardiac patient. Every sixth one has moderate or severe depression, which calls for special attention. Research in personal time perspective has good prospects for psychological interventions.

Disclosure

No significant relationships.

Attitudes of preoperative cardiac surgery patients toward COVID-19: A cause for concern

Introduction

During the pandemic, many surveys studied people’s attitude to COVID-19. However, less information is available about the peculiarities of such attitude of the most vulnerable groups including chronic somatic patients who are in need of operative treatment.

Objectives

To identify the specificity of preoperative cardiac surgery patients’ attitudes toward COVID-19 as compared to that of healthy people.

Methods

We used the Attitudes towards COVID-19 questionnaire (Nikolaev E.) to survey 60 preoperative cardiac patients and 327 healthy university students. Difference validity was assessed with significance level of p<0.05.

Results

Cardiac patients are more likely to trust the government measures to fight COVID-19 (t=3.131; p=.002), and their COVID-19-related fears for their life are higher (t=2.793; p=.005). As compared to healthy people, patients are less likely to think that pandemic broke their customary way of life (t=-2.793; p=.005) and plans for the future (t=-3.337; p=.000). Credibly more often than healthy people, cardiac surgery patients consider that it is useless to wear a mask and limit contacts, as any person will eventually catch the virus (t=2.401; p=.017). We did not reveal any more evidently expressed COVID-19-related anxiety in preoperative cardiac surgery patients.

Conclusions

Attitudes of cardiac surgery patients toward COVID-19 manifest in an adequate assessment of threat to their personal health, trust in the government measures, and readiness to change their daily plans. It is latent fatalistic ideas about ultimate uselessness of restrictive measures that pose threat to people’s own health and the health of the people around them, which health professionals should remember in their preventive actions.

Disclosure

No significant relationships.

Cell-Mediated Immune Responses to COVID-19 Infection

An unprecedented outbreak of pneumonia caused by a novel coronavirus (CoV), subsequently termed COVID-19 by the World Health Organization, emerged in Wuhan City (China) in December 2019. Despite rigorous containment and quarantine efforts, the incidence of COVID-19 continues to expand, causing explosive outbreaks in more than 160 countries with waves of morbidity and fatality, leading to significant public health problems. In the past 20 years, two additional epidemics caused by CoVs have occurred: severe acute respiratory syndrome-CoV, which has caused a large-scale epidemic in China and 24 other countries; and respiratory syndrome-CoV of the Middle East in Saudi Arabia, which continues to cause sporadic cases. All of these viruses affect the lower respiratory tract and manifest as pneumonia in humans, but the novel SARS-Cov-2 appears to be more contagious and has spread more rapidly worldwide. This mini-review focuses on the cellular immune response to COVID-19 in human subjects, compared to other clinically relevant coronaviruses to evaluate its role in the control of infection and pathogenesis and accelerate the development of a preventive vaccine or immune therapies.

Methodology for identification and quantification of chicken meat in food products

Introduction. The problem of food adulteration is highly relevant today. Food manufacturers are increasingly replacing expensive raw materials with cheaper poultry. We aimed to develop an effective method for identification and quantification of chicken meat and egg products in multicomponent meat systems using real-time PCR. Study objects and methods. We studied native animal tissue, namely that of chicken, pork, beef, turkey, quail, duck, horse meat, rabbit, sheep, and goat. Standard samples were taken from pure fresh chicken muscle tissue. We also used raw, boiled, and powdered chicken eggs. For a semiquantitative analysis of chicken mass in the sample, we compared the threshold cycle (Ct) of chicken DNA and the threshold cycles of calibration samples. To ensure the absence of PCR inhibition, we used an internal control sample which went through all the stages of analysis, starting with DNA extraction. Results and discussion. We developed a methodology to qualitatively determine the content of chicken tissue in the product and distinguish between the presence of egg products and contamination on the production line. The method for chicken DNA identification showed 100% specificity. This genetic material was detected in the range of 0.1% to 0.01% of chicken meat in the sample. The efficiency of the duplex PCR system for chicken DNA detection was more than 95% (3.38 on the Green slope channel and 3.45 on the Yellow slope channel). The analytical sensitivity of the primers was 40 copies/reaction. Conclusion. Our methodology is suitable for analyzing multicomponent food products, raw materials, feed, and feed additives. It can identify the content of chicken meat at a concentration of up to 1%, as well as distinguish egg impurities from contamination of various origin. PCR allows differentiation between chicken meat and egg products.

Time-Reversed Particle-Vibration Loops and Nuclear Gamow-Teller Response

The nuclear response theory for charge-exchange modes in the relativistic particle-vibration coupling approach is extended to include for the first time particle-vibration coupling effects in the ground state of the parent nucleus. In a framework based on the effective meson-nucleon Lagrangian, we investigate the role of such complex ground-state correlations in the description of Gamow-Teller transitions in ^{90}Zr in both (p, n) and (n, p) channels. The particle-vibration coupling effects are calculated without introducing new parameters. We find that this new correlation mechanism is fully responsible for the appearance of the strength in the (n, p) branch. Comparison of our results to the available experimental data shows a very good agreement up to excitation energies beyond the giant resonance region when taking into account a phenomenological admixture of the isovector spin monopole transitions. The parent-daughter binding-energy differences are also greatly improved by the inclusion of the new correlations.

Dietary fibres in preventative meat products

This paper is based on literature and our own studies of high-quality dietary fibres of various types, as well as food materials and products. It provides data on the physiological features, functional and technological properties of dietary fibre, as well as its main uses in food technology. In particular, we assessed the texture of dietary fibre, constructed rheograms for the flow of fibre-water systems, and analysed the histological structure. Our results form a scientific basis for the development of safe meat products of high quality and healthy diets. We established specific structural characteristics, properties, and rheological behaviour of various dietary fibres, as well as their advantages. We found that potato fibres demonstrated greater uniformity in texture and rheology, compared to wheat fibres. Wheat fibres had a clear phase structure (fibre/water), whereas potato fibres showed significant hydrophilic and structuring properties, attributing them to colloidal fibres. The established patterns contribute to the rational selection of dietary fibre to create products with desired properties. In particular, we developed a technology for a restructured poultry product with preventative properties using soluble and insoluble dietary fibres. The paper provides data on the product’s safety indicators, nutritional and biological values, as well as functional, technological, microbiological, and other properties. We also conducted microstructural studies to analyse the uniformity of distribution of the curing mixture in the developed meat product. We concluded that using potato and wheat fibres can expand the range of meat products in line with the concepts of rational and healthy nutrition, as well as increase the product’s succulence and prevent syneresis and mass loss.

The (Fab)ulous Destiny of Idarucizumab: Highlighting Its Interference with Urine Protein Immunofixation

Idarucizumab is a humanized antigen binding fragment (Fab) of a recombinant anti-dabigatran monoclonal antibody (IgG1-kappa) that allows rapid and sustained reversal of dabigatran-induced anticoagulation in case of bleeding or urgent surgery. Herein, we report a very unusual case of dabigatran reversal by idarucizumab in a 79-year-old woman with acute kidney failure admitted to a hospital in a context of hemoptysis. Three repeated injections were necessary because of massive dabigatran overdose and high rebounds of dabigatran plasma concentration. Idarucizumab was found on urine immunofixation up to 6 days after the last injection where it reacted with anti-kappa light chain antibody, but not with anti-gamma heavy chain antibody. Physicians should be aware of the increased half-life of idarucizumab in this context of acute kidney impairment and of its interference with urine immunofixation because it could lead to false-positive results and misdiagnosis of a paraprotein.

Nuclear response at zero and finite temperature

We present some recent developments on the nuclear many-body problem, such as the treatment of high-order correlations and finite temperature in the description of in-medium two-nucleon propagators. In this work we discuss two-time propagators of the particle-hole type, which describe the response of finite nuclei to external probes without nucleon transfer. The general theory is formulated in terms of the equation of motion method for these propagators with the only input from the bare nucleon-nucleon interaction. The numerical implementation was performed on the basis of the effective mason-nucleon Lagrangian in order to study the energy-dependent kernels of different complexity. The finite-temperature extension of the theory with ph ⊗ phonon configurations is applied to a study of the multipole response of medium-mass nuclei.

Prevalence and Significance of Non-conventional Antiphospholipid Antibodies in Patients With Clinical APS Criteria

Background: The biological diagnostics of antiphospholipid syndrome (APS) takes into account the persistent positivity for anticardiolipin and/or anti-β2GP1 antibodies and/or presence of lupus anticoagulant (LA). However, some non-conventional antiphospholipid antibodies have emerged that could help in the diagnosis of APS.

Objectives: To study the potential usefulness of non-conventional antiphospholipid antibodies in clinical practice.

Methods: Eighty-seven patients, aged from 15 to 92 years were included and classified in following groups: 41 patients positive for the conventional antibodies with clinical criterion of APS (31 with primary APS and 10 secondary), 17 seronegative APS (SNAPS) patients (i.e., persistent negativity for the conventional antibodies with a strong clinical suspicion of APS), 11 asymptomatic antiphospholipid antibodies carriers (i.e., persistent positivity for the conventional antibodies without clinical evidence of APS), and 18 patients presenting with a first thrombotic or obstetrical event. IgG and IgM were detected to the following antigens: phosphatidylserine/prothrombin (PS/PT) by ELISA, and phosphatidic acid, phosphatidyl-ethanolamine, phosphatidyl-glycerol, phosphatidyl-inositol, phosphatidylserine, annexin V, prothrombin by immunodot. Anti-β2GP1 IgA, and anti-β2GP1 domain 1 IgG were detected by chemiluminescence.

Results: Positivity for the non-conventional antibodies was correlated with APS severity; patients with catastrophic APS (CAPS) being positive for 10.7 (Median, Range: 5–14) non-conventional antibodies. 9/17 seronegative patients were positive for at least one of non-conventional antibodies. A study of non-supervised hierarchical clustering of all markers revealed that anti-PS/PT antibodies showed high correlation with the presence of LA. All patients with APS triple positivity (highest risk profile) exhibited also persistent positivity for anti-PS/PT antibodies.

Conclusions: Our data obtained from a prospective cohort constituted mainly by patients with primary APS, suggest that non-conventional APS antibodies may be useful for patients classified as SNAPS. They demonstrate the potential value of aPS/PT antibodies as a strong marker of APS. We propose that anti-PS/PT antibodies could be a surrogate APS biological marker of LA to classify in high-risk profile patients treated by direct oral anticoagulants (DOACs), in whom LA detection cannot be achieved.

Finite-Temperature Relativistic Nuclear Field Theory: An Application to the Dipole Response

Nuclear response theory beyond the one-loop approximation is formulated for the case of finite temperature. For this purpose, the time blocking approximation to the time-dependent part of the in-medium nucleon-nucleon interaction amplitude is adopted for the thermal (imaginary-time) Green's function formalism. We found that introducing a soft blocking, instead of a sharp blocking at zero temperature, brings the Bethe-Salpeter equation to a single-frequency variable equation also at finite temperatures. The method is implemented self-consistently in the framework of quantum hadrodynamics and designed to connect the high-energy scale of heavy mesons and the low-energy domain of nuclear medium polarization effects in a parameter-free way. In this framework, we investigate the temperature dependence of dipole spectra in the even-even nuclei ^{48}Ca and ^{100,120,132}Sn with a special focus on the giant dipole resonance's width problem and on the low-energy dipole strength distribution.

Isospin dynamics in nuclear structure

We discuss some special aspects of the nuclear many-body problem related to isospin transfer. The major quantity of interest is the in-medium propagator of a particlehole configuration of the proton-neutron character, which determines the nuclear response to isospin transferring external fields. One of the most studied excitation modes is the Gamow-Teller resonance (GTR), which can, therefore, be used as a sensitive test for the theoretical approaches. Its low-energy part, which is responsible for the beta decay halflives, is especially convenient for this. Models benchmarked against the GTR can be used to predict other, more exotic, excitations studied at nuclear rare isotope beam facilities and in astrophysics. As far as the precision is concerned, the major problem in such an analysis is to disentangle the effects related to the underlying interaction and those caused by the many-body correlations. Therefore, approaches (i) based on fundamental concepts for the nucleon-nucleon interaction which (ii) include complex many-body dynamics are the preferred ones. We discuss progress and obstacles on the way to such approaches.

Observation of the Isovector Giant Monopole Resonance via the ^{28}Si(^{10}Be,^{10}B^{*}[1.74 MeV]) Reaction at 100 AMeV

The (^{10}Be,^{10}B^{*}[1.74  MeV]) charge-exchange reaction at 100  AMeV is presented as a new probe for isolating the isovector (ΔT=1) nonspin-transfer (ΔS=0) response of nuclei, with ^{28}Si being the first nucleus studied. By using a secondary ^{10}Be beam produced by fast fragmentation of ^{18}O nuclei at the NSCL Coupled Cyclotron Facility, applying the dispersion-matching technique with the S800 magnetic spectrometer to determine the excitation energy in ^{28}Al, and performing high-resolution γ-ray tracking with the Gamma-Ray Energy Tracking In-beam Nuclear Array (GRETINA) to identify the 1022-keV γ ray associated with the decay from the 1.74-MeV T=1 isobaric analog state in ^{10}B, a ΔS=0 excitation-energy spectrum in ^{28}Al was extracted. Monopole and dipole contributions were determined through a multipole-decomposition analysis, and the isovector giant dipole resonance and isovector giant monopole resonance (IVGMR) were identified. The results show that this probe is a powerful tool for studying the elusive IVGMR, which is of interest for performing stringent tests of modern density functional theories at high excitation energies and for constraining the bulk properties of nuclei and nuclear matter. The extracted distributions were compared with theoretical calculations based on the normal-modes formalism and the proton-neutron relativistic time-blocking approximation. Calculated cross sections based on these strengths underestimate the data by about a factor of 2, which likely indicates deficiencies in the reaction calculations based on the distorted wave Born approximation.

[OUTPATIENT ANTIMICROBIAL TREATMENT FOR ACUTE TONSILLOPHARYNGITIS]

One of the most significant problems in antimicrobial therapy (AMT) is widespread administration of antimicrobial agents without relevant medical conditions. The aim of the research was the analysis of antimicrobial agent prescribing practices for outpatient treatment of acute tonsillopharyngitis at the Karaganda Polyclinic №1 and Polyclinic №2. The analysis of antimicrobial agents prescribing practices for outpatient treatment of acute tonsillopharyngitis was conducted; medical records of outpatients with acute tonsillopharyngitis treated in 2014 at Polyclinics №1 and №2 were analyzed.

INCLUSION CRITERIA

patients ranging in age from18 to 44, verified diagnosis - acute tonsillopharyngitis. It was found that in all cases antimicrobial agents have been prescribed speculatively, without previous bacteriological study or method of express diagnostics of Group A beta-hemolytic streptococcus (GABHS). In a majority of cases β-lactams were prescribed. Flemoxin Solutab was the most commonly prescribed β-lactam in Polyclinic №1; Amoxicillin was the most commonly prescribed β-lactam at Polyclinic №2; it associated with personal experience of administration of these agents rather than data of evidentiary medicine. Study of actual medicine administration showed that in half of the cases dosage regimen, rout of administration, dosage and treatment session duration have not been followed. For the development of clinical guidelines for rational treatment of acute tonsillopharyngitis is necessary to study the local spectrum of the major pathogens and their antimicribial resistance.

Complete electric dipole response and the neutron skin in 208Pb

A benchmark experiment on (208)Pb shows that polarized proton inelastic scattering at very forward angles including 0° is a powerful tool for high-resolution studies of electric dipole (E1) and spin magnetic dipole (M1) modes in nuclei over a broad excitation energy range to test up-to-date nuclear models. The extracted E1 polarizability leads to a neutron skin thickness r(skin) = 0.156(-0.021)(+0.025) fm in (208)Pb derived within a mean-field model [Phys. Rev. C 81, 051303 (2010)], thereby constraining the symmetry energy and its density dependence relevant to the description of neutron stars.

An inhibitor of cyclin-dependent kinases suppresses TLR signaling and increases the susceptibility of cancer patients to herpesviridae

Cyclin-dependent kinase (CDK) inhibitors have been considered as excellent drug candidates for cancer therapy owing to their potential capacity to restore cell cycle control. The first generation of CDK inhibitors showed modest clinical advantages that could be attributed to off-target effects preventing them from reaching therapeutic concentrations. A phase I dose-escalation study using the second generation multi-CDK inhibitor PHA-793887 was conducted on a total of 19 patients with advanced refractory malignancies in two sites in Europe: the University of Leeds and St. James's Institute of Oncology, Leeds, UK, and the Institut Gustave Roussy, Villeujf, France (IGR). Fifteen patients were treated at IGR. Six among these patients manifested the reactivation of herpes virus replication. In vitro experiments revealed that PHA-793887 severely impaired signaling by toll-like receptors (such as TLR3, TLR4 and TLR9) in dendritic cells (DC), thus suppressing the production of multiple cytokines (type 1 interferon, interleukin-6,-10, -12, and tumor necrosis factorα) by mature DC, as well as the DC-stimulated production of interferon-γ by natural killer cells. Pharmacological inhibition of glycogen synthase-3β (GSK-3β), one of the off-targets of PHA-793887, did not cause such immunological defects. Altogether, these data underscore a hitherto unsuspected immunosuppressive effect of PHA-793887.

Isospin character of the pygmy dipole resonance in 124Sn

The pygmy dipole resonance has been studied in the proton-magic nucleus 124Sn with the (α, α'γ) coincidence method at Eα=136 MeV. The comparison with results of photon-scattering experiments reveals a splitting into two components with different structure: one group of states which is excited in (α, α'γ) as well as in (γ, γ') reactions and a group of states at higher energies which is only excited in (γ, γ') reactions. Calculations with the self-consistent relativistic quasiparticle time-blocking approximation and the quasiparticle phonon model are in qualitative agreement with the experimental results and predict a low-lying isoscalar component dominated by neutron-skin oscillations and a higher-lying more isovector component on the tail of the giant dipole resonance.

Mode coupling and the pygmy dipole resonance in a relativistic two-phonon model

A new class of many-body models, based on covariant density functional theory for excited states, is presented. It allows a parameter free description of the fragmentation of nuclear states induced by mode coupling of two-quasiparticle and two-phonon configurations. As compared to earlier methods it provides a consistent and parameter free theory of the fine structure of nuclear resonances. The method is applied very successfully to investigate the newly discovered low-lying dipole excitations in Sn and Ni isotopes with large neutron excess.

Regulatory and Effector T Cell Activation Levels Are Prime Determinants of In Vivo Immune Regulation

Little is known about the in vivo conditions in which CD4+CD25+ regulatory T cells (T(reg)) exert their suppressive effect in nonlymphopenic mice. To this end, we analyzed T(reg)-mediated suppression of expansion and cytokine production at different levels of Ag-specific CD4+CD25- T cell activation. Using Ab-mediated depletion of endogenous T(reg), we show that basal immunosuppression is dependent on effector T cell activation. These polyclonal T(reg), which were poorly activated in our immunization conditions, were effective in weak but not high T cell activation context. In contrast, the same immunization conditions led to proliferation of cotransferred Ag-specific T(reg). Those efficiently inhibited T cell proliferation and cytokine production even in strong T cell activation context. Interestingly, T(reg) selectively suppressed expansion or cytokine production depending on the experimental approach. The importance of the immune context for efficient suppression is further supported by the observation that T(reg) depletion exacerbated diabetes of NOD mice only at the early stage of the disease. Overall, our study suggests that T(reg)-mediated suppression depends on the relative activation of T(reg) and effector T cells in vivo. This balance may be a critical factor in the regulation of immune responses.

Microscopic nature of the pygmy dipole resonance: the stable Ca isotopes

The electric dipole strength distribution in 44Ca has been measured up to 10 MeV in high resolution photon scattering experiments for the first time. The data obtained have been compared to earlier measurements on (40,48)Ca in order to view the evolution of the electric pygmy dipole resonance (PDR). Calculations that were performed within the framework of the microscopic extended theory of finite Fermi systems, which adds contributions of the quasiparticle-phonon coupling to random phase approximation calculations, give a qualitative agreement with the experimental data for all three isotopes. We have shown that it is necessary to include this coupling to describe the PDR.

Continuous activation of autoreactive CD4+ CD25+ regulatory T cells in the steady state

Despite a growing interest in CD4+ CD25+ regulatory T cells (Treg) that play a major role in self-tolerance and immunoregulation, fundamental parameters of the biology and homeostasis of these cells are poorly known. Here, we show that this population is composed of two Treg subsets that have distinct phenotypes and homeostasis in normal unmanipulated mice. In the steady state, some Treg remain quiescent and have a long lifespan, in the order of months, whereas the other Treg are dividing extensively and express multiple activation markers. After adoptive transfer, tissue-specific Treg rapidly divide and expand preferentially in lymph nodes draining their target self-antigens. These results reveal the existence of a cycling Treg subset composed of autoreactive Treg that are continuously activated by tissue self-antigens.

Graft-versus-leukemia effect after suicide-gene-mediated control of graft-versus-host disease

Clinical data indicate that after allogeneic hematopoietic stem cell transplantation (HSCT) for hematological malignancies, the graft-versus-leukemia (GVL) effect is in large part mediated by the graft-versus-host reaction (GVHR), which also often leads to graft-versus-host disease (GVHD). Controlling alloreactivity to prevent GVHD while retaining GVL poses a true dilemma for the successful treatment of such malignancies. We reasoned that suicide gene therapy, which kills dividing cells expressing the thymidine kinase (TK) "suicide" gene using time-controlled administration of ganciclovir (GCV), might solve this dilemma. We have previously shown that after infusion of allogeneic TK T cells along with HSCT to an irradiated recipient, an early and short GCV treatment efficiently prevents GVHD by selectively eliminating alloreactive T cells while sparing nonalloreactive T cells, which can then contribute to immune reconstitution. Nevertheless, it remained to be established that this therapeutic strategy retained the desired GVL effect. Hypothesizing that a contained GVHR would be essential, we evaluated the GVL effect using different protocols of GCV administration. We were able to show that when the GCV treatment is initiated at, or close to, the time of grafting, GVHD is controlled but GVL is lost. In contrast, when the onset of GCV administration is delayed until day 6, a potent GVL effect is retained while GVHD is still controlled. These data emphasize that, by a time-optimized scheduling of the administration of GCV, this TK/GCV strategy can be tuned to efficiently treat malignant hemopathies.

Effect of combined cytostatic cyclosporin A and cytolytic suicide gene therapy on the prevention of experimental graft-versus-host disease

The immunosuppressive drug cyclosporin A (CsA) represents the standard preventive treatment of graft-versus-host disease (GVHD), the main complication of allogeneic hematopoietic stem cell transplantation (HSCT). However, its efficacy is only partial and many patients develop lethal GVHD despite CsA. A strategy of genetic immunosuppression based on conditional elimination of donor T cells expressing the Herpes simplex type 1 thymidine kinase (TK) suicide gene was recently developed. In this system, ganciclovir (GCV) selectively kills dividing but not quiescent TK T cells. Since CsA is known to have a cytostatic effect on T cells, it could negatively interfere with the division-dependent TK gene therapy. We thus tested whether administration of CsA would antagonize elimination of alloreactive donor TK T cells mediated by GCV in a murine model of GVHD. In vivo experiments revealed that, contrary to GCV, CsA only transiently controlled alloactivation-induced T cell proliferation, and likewise could not prevent lethal GVHD. When T cells resumed proliferation under CsA, they were however still sensitive to GCV. Survival, as well as immune reconstitution, was excellent in mice treated with GCV alone or in combination with CsA. These observations should help to design improved suicide gene therapy trials in the field of allogeneic HSCT.

Effects of CSFS and their combinations with chemotherapeutic agents (CH) on leukemic blasts (LB) in children (MTT-assay)

Thirty-five samples of bone marrow (BM) from 17 patients (pts) with ALL and 18 pts with AML (aged 9 m-20 yrs, median 7.7 yrs) were obtained. Using MTT-assay the sensitivity of LB to Ara-C, VP-16, DOX, G(GM)-CSF and their combinations was measured. LC50 was higher in pts with AML than with ALL: to Ara-C 1.94-fold (p < 0.05), to VP-16 1.62-fold (p = 0.2), to DOX 3.9-fold (p < 0.05). Incubation with G-CSF increased the viability of ALL and AML LB--104.3% and 104.1% respectively (the viability of leukemic cells without CSF accepted as 100%). Incubation with GM-CSF decreased the viability of ALL LB (96.5%) and increased the viability of AML LB (139.1%) (p = 0.08). Combining Ara-C with G- or GM-CSF resulted in equal or increased LC50 (compared with LC50 of Ara-C alone) in 100% cases of AML. For ALL: LC50 of "Ara-C+G-CSF" was equal or increased in 63.6% cases; LC50 of "Ara-C+GM-CSF"-in 62.5%. For VP-16 and DOX all pts (ALL, AML) except two had equal or increased LC50 of "CH+CSF" (compared with LC50 of CH alone). These data show: 1) AML LB were less sensitive to the investigated CH than ALL LB. 2) The LC50 of "CH+CSF" was equal or increased compared to the LC50 of CH for the absolute majority of cases with VP-16 and DOX. The same results were obtained with AML and in about 60% cases of ALL. The effect of the increasing of cytototoxity of CH in presence of CSF probably exists mostly at higher concentrations of CH than those that can be achieved in clinical practice.