Myositis-Associated Autoantibodies in Patients With Juvenile Myositis Are Associated With Refractory Disease and Mortality

OBJECTIVE

Myositis-associated autoantibodies (MAAs) have been associated with overlap myositis, certain disease manifestations such as interstitial lung disease (ILD), and worse prognosis in the idiopathic inflammatory myopathies. MAAs overall remain largely uncharacterized in patients with juvenile-onset myositis. Moreover, it is unknown whether the number of MAAs is associated with disease severity.

METHODS

Patients with juvenile myositis in cross-sectional natural history studies who underwent testing for myositis autoantibodies were included. Demographics, myositis autoantibodies, clinical characteristics, medications received, and outcomes of those with and without MAAs were compared. Multivariable logistic regression was performed to determine whether the number of MAAs detected was associated with severe disease features.

RESULTS

Among 551 patients, 36% had an MAA and 13% had more than one MAA. Among those who were MAA positive, there was a higher frequency of overlap myositis (18% vs 5.9%, P < 0.001). MAA positivity was associated with certain clinical features, including Raynaud phenomenon (odds ratio [OR] 2.44, 95% confidence interval [CI] 1.41-4.28) and ILD (OR 3.43, 95% CI 1.75-6.96), as well as a chronic disease course (OR 1.72, 95% CI 1.10-2.72) and mortality (OR 3.76, 95% CI 1.72-8.43). The number of MAAs was also associated with mortality (OR 1.83, 95% CI 1.16-2.86).

CONCLUSION

MAAs were prevalent in a large cohort of patients with juvenile myositis. ILD, refractory disease, and mortality were associated with MAA positivity. Prospective studies are needed to determine whether early detection of MAAs may lead to improved outcomes for patients with juvenile myositis.

Prurigo Nodularis Is Characterized by Systemic and Cutaneous T Helper 22 Immune Polarization

Prurigo nodularis (PN) is an understudied, chronic inflammatory skin disease that disproportionately affects African Americans and presents with intensely pruritic nodules of unknown etiology. To better characterize the immune dysregulation in PN, PBMCs and skin biopsies were obtained from patients with PN and healthy subjects (majority African American) matched by age, race, and sex. Flow cytometric analysis of functional T-cell response comparing patients with PN with healthy subjects identified increased γδT cells (CD3+CD4-CD8-γδTCR+) and Vδ2+ γδT enrichment. Activated T cells demonstrated uniquely increased IL-22 cytokine expression in patients with PN compared with healthy controls. CD4+ and CD8+ T cells were identified as the source of increased circulating IL-22. Consistent with these findings, RNA sequencing of lesional PN skin compared with nonlesional PN skin and biopsy site‒matched control skin demonstrated robust upregulation of T helper (Th) 22‒related genes and signaling networks implicated in impaired epidermal differentiation. Th22‒related cytokine upregulation remained significant, with stratifications by race and biopsy site. Importantly, the expression of the IL-22 receptors IL22RA1 and IL22RA2 was significantly elevated in lesional PN skin. These results indicate that both systemic and cutaneous immune responses in patients with PN are skewed toward a Th22/IL-22 profile. PN may benefit from immunomodulatory therapies directed at Th22‒mediated inflammation.

Chlorophyll(a)/Carbon Quantum Dot Bio-Nanocomposite Activated Nano-Structured Silicon as an Efficient Photocathode for Photoelectrochemical Water Splitting

Solar-driven water splitting is considered as a futuristic sustainable way to generate hydrogen and chemical storage of solar energy. Further, considering the technological competence, silicon is one of the potential materials for developing large-scale and cost-effective photocathodes (PCs), but it lacks efficacy and stability. Here, we show that chlorophyll(a)/carbon quantum dots (Chl/CQDs) bio-nanocomposite (b-NC)-decorated Si-nanowires (SiNWs) as PC can surpass the reported efficiency for photoelectrochemical (PEC) hydrogen generation along with stability. The optimized heterojunction (Chl/CQDs_SiNW) significantly enhances broad-band solar absorption and protects Si surface from corrosion. Further, the appropriate band alignment enforces efficient photogenerated charge separation and possesses directional exciton transport property via the Förster resonance energy transfer (FRET) mechanism. This synergic effect demonstrates an ∼18 times increase in photocurrent density (26.36 mA/cm²) compared to pristine SiNW PC at 1.07 V vs reversible hydrogen electrode (RHE). The efficiency reaches ∼7.86%, which is comparably the highest reported for hybrid Si-based photocathodes. Hydrogen evaluation rate was measured to be ∼113 μmol/h at 0.8 V vs RHE under 1 sun illumination. With Si-process line compatibility, this new finding opens a new direction toward the development of Si-based efficient and stable PCs at a large scale for commercial applications.

Surface Plasmon-Enhanced Carbon Dot-Embellished Multifaceted Si(111) Nanoheterostructure for Photoelectrochemical Water Splitting

Because of the excellent electronic properties, Si is a well-established semiconducting material for PV technology. However, slow kinetics and a fast corroding nature make Si inefficient for the hydrogen evolution reaction (HER) in photoelectrochemical (PEC) applications. Herein, we demonstrate a multifacet Si nanowire (SiNW) decorated with surface plasmon-enhanced carbon quantum dots (AuCQDs) as efficient, stable, economical, and scalable photocathodes (PCs) for HER. The PEC performance of SiNW_AuCQDs has more than a fourfold efficiency enhancement than the pristine SiNW, which we have attributed to the combined effect of enhanced solar absorption and efficient carrier transport. The optimized PC SiNW_AuCQDs results in the highest photocurrent ∼1.7 mA/cm², an applied bias photon-to-current conversion efficiency of ∼0.8%, and H₂ gas evolution rate of ∼182.93 μmol·h^-1. Furthermore, these SiNW_AuCQDs PCs provide extraordinary stability under continuous operating conditions with 1 sun illumination (100 mW/cm²). The process-line compatible fabrication process of these PCs will open a new direction at the wafer-level designing of a heterostructure for large-scale solar-fuel conversion.

Single In x Ga1-x As nanowire/p-Si heterojunction based nano-rectifier diode

Nanoscale power supply units will be indispensable for fabricating next generation smart nanoelectronic integrated circuits. Fabrication of nanoscale rectifier circuits on a Si platform is required for integrating nanoelectronic devices with on-chip power supply units. In the present study, a nanorectifier diode based on a single standalone In _x Ga_1-x As nanowire/p-Si (111) heterojunction fabricated by metal organic chemical vapor deposition technique has been studied. The nanoheterojunction diodes have shown good rectification and fast switching characteristics. The rectification characteristics of the nanoheterojunction have been demonstrated by different standard waveforms of sinusoidal, square, sawtooth and triangular for two different frequencies of 1 and 0.1 Hz. Reverse recovery time of around 150 ms has been observed in all wave response. A half wave rectifier circuit with a simple capacitor filter has been assembled with this nanoheterojunction diode which provides 12% output efficiency. The transport of carriers through the heterojunction is investigated. The interface states density of the nanoheterojunction has also been determined. Occurrence of output waveforms incommensurate with the input is attributed to higher series resistance of the diode which is further explained considering the dimension of p-side and n-side of the junction. The sudden change of ideality factor after 1.7 V bias is attributed to recombination through interface states in space charge region. Low interface states density as well as high rectification ratio makes this heterojunction diode a promising candidate for future nanoscale electronics.

Synthesis of graphene oxide–silver nanocomposite with photochemically grown silver nanoparticles to use as a channel material in thin film field effect transistors

The transport of charge carriers in a graphene oxide–silver nanoparticle composite is found to be controlled by nanoparticle dose.

Leakage current characteristics in MOCVD grown InAs quantum dot embedded GaAs metal-oxide-semiconductor capacitor

Carrier transport vis-a-vis leakage current in GaAs MOS capacitors with various structures; quantum dot embedded devices show the lowest leakage.

Tie2-dependent knockout of HIF-1 impairs burn wound vascularization and homing of bone marrow-derived angiogenic cells

AIMS

Hypoxia-inducible factor 1 (HIF-1) is a heterodimer composed of HIF-1α and HIF-1β subunits. HIF-1 is known to promote tissue vascularization by activating the transcription of genes encoding angiogenic factors, which bind to receptors on endothelial cells (ECs) and bone marrow-derived angiogenic cells (BMDACs). In this study, we analysed whether HIF-1 activity in the responding ECs and BMDACs is also required for cutaneous vascularization during burn wound healing.

METHODS AND RESULTS

We generated mice with floxed alleles at the Hif1a or Arnt locus encoding HIF-1α and HIF-1β, respectively. Expression of Cre recombinase was driven by the Tie2 gene promoter, which is expressed in ECs and bone marrow cells. Tie2Cre(+) and Tie2Cre(-) mice were subjected to burn wounds of reproducible diameter and depth. Deficiency of HIF-1α or HIF-1β in Tie2-lineage cells resulted in delayed wound closure, reduced vascularization, decreased cutaneous blood flow, impaired BMDAC mobilization, and decreased BMDAC homing to burn wounds.

CONCLUSION

HIF-1 activity in Tie2-lineage cells is required for the mobilization and homing of BMDACs to cutaneous burn wounds and for the vascularization of burn wound tissue.

Aging impairs the mobilization and homing of bone marrow-derived angiogenic cells to burn wounds

Impaired wound healing in the elderly represents a major clinical problem. Delineating the cellular and molecular mechanisms by which aging impairs wound healing may lead to the development of improved treatment strategies for elderly patients with non-healing wounds. Neovascularization is an essential step in wound healing, and bone marrow-derived angiogenic cells (BMDACs) play an important role in vascularization. Using a mouse full-thickness burn wound model, we demonstrate that perfusion and vascularization of burn wounds were impaired by aging and were associated with dramatically reduced mobilization of BMDACs bearing the cell surface molecules CXCR4 and Sca1. Expression of stromal-derived factor 1 (SDF-1), the cytokine ligand for CXCR4, was significantly decreased in peripheral blood and burn wounds of old mice. Expression of hypoxia-inducible factor (HIF)-1α was detected in burn wounds from young (2-month-old), but not old (2-year-old), mice. When BMDACs from young donor mice were injected intravenously, homing to burn wound tissue was impaired in old recipient mice, whereas the age of the BMDAC donor mice had no effect on homing. Our results indicate that aging impairs burn wound vascularization by impairing the mobilization of BMDACs and their homing to burn wound tissue as a result of impaired HIF-1 induction and SDF-1 signaling.

Effects of aging and hypoxia-inducible factor-1 activity on angiogenic cell mobilization and recovery of perfusion after limb ischemia

Ischemia is a stimulus for production of angiogenic cytokines that activate local vascular cells and mobilize angiogenic cells to the circulation. These responses are impaired in elderly patients with peripheral arterial disease. Hypoxia-inducible factor (HIF)-1 mediates adaptive responses to ischemia, including production of angiogenic cytokines. In this study, we demonstrate that aging and HIF-1 loss-of-function impair the expression of multiple angiogenic cytokines, mobilization of angiogenic cells, maintenance of tissue viability, and recovery of limb perfusion following femoral artery ligation. We show that HIF-1 directly activates transcription of the gene encoding stem cell factor and that mice lacking the cognate receptor C-KIT have impaired recovery from ischemia. Administration of AdCA5, an adenovirus encoding a constitutively active form of HIF-1alpha, improved the recovery of perfusion in older mice to levels similar to those in young mice. Injection of AdCA5 into nonischemic limb was sufficient to increase the number of circulating angiogenic cells. These results indicate that HIF-1 activity is necessary and sufficient for the mobilization of angiogenic cells and that HIF-1alpha gene therapy can counteract the pathological effects of aging in a mouse model of limb ischemia.

Selective inhibition by rottlerin of macropinocytosis in monocyte-derived dendritic cells

We present here the analysis of fluid-phase endocytosis (FPE) in human blood monocytes and monocyte-derived dendritic cells (MDDC) facilitated by our serendipitous identification of rottlerin as an efficient inhibitor of dendritic cell FPE (IC(50) of 0.4 microM). Rottlerin was found to be an excellent tool for FPE analysis: rapid-acting, irreversible and selective for FPE (as opposed to receptor-mediated endocytosis) at concentrations of 3 microM and below. The inhibitory effect was not due to toxicity or visible change in membrane ruffles, but affects on cytoskeletal reorganization were evident in MDDC treated with relevant rottlerin concentrations during adhesion. A marked increase in FPE was observed in 1 hr interleukin (IL)-4 and granulocyte macrophage-colony stimulating factor (GM-CSF)-stimulated monocytes. Moreover, rottlerin inhibited the augmented FPE of 1-day cytokine treated monocytes and their augmented ability to induce T cell proliferative responses to tetanus toxoid. We conclude that rottlerin is a useful tool for investigating FPE and its functional importance.

Epidemiology of HIV infection among brothel-based sex workers in Kolkata, India

A cross-sectional study was carried out during January-June 2004 to assess the status of HIV infection among brothel-based sex workers in Kolkata city, India. Six hundred and twenty-two sex workers, selected from six brothels, were included in the study to assess their HIV status, and 362 sex workers, a subset of the above population, were interviewed to study their risk behaviour and practices. Blood samples were collected from each sex worker for testing HIV by an unlinked anonymous method. The prevalence of HIV infection was 9.6%, but was much higher among younger sex workers aged 20 years or less (27.7%) compared to the older age group (8.4%). This difference was statistically significant, indicating an association of younger ages with HIV infection [p = 0.006 and odds ratio (OR) = 4.18; (95% confidence interval (CI) 1.2-13.8)]. HIV was not associated with duration of sex work, average number of clients entertained per day, condom use, practice of sex during menstruation, pre-coital examination of penis for visible ulcer/discharge, suffering from sexually transmitted infections, and entertaining clients outside the brothel. There was a big gap between the reported and the evaluated condom use by sex workers. The results suggest that there is a need to develop suitable HIV intervention strategies, considering the socioeconomic and cultural aspects of city sex workers, with a provision for continuous monitoring and evaluation.

Biomonitoring insecticide pollution using non-target soil microarthropods

The scope of biomonitoring insecticide pollution in soil is discussed with the help of field and laboratory findings on the density, prey-predator ratio and fecundity of non-target microarthropod fauna. Field experiments were conducted in small plots with mustard, wheat and lady's finger crops and insecticides namely heptachlor 20EC (3.25 kg ai/ha = 16.25 lit/ha) and endosulfan 35EC (0.875 kg ai/ha = 2.5 lit/ha) applied at the seedling stages. Soil microarthropod population estimated at fortnightly intervals in the treated and untreated control plots revealed a general trend of adverse effect of the insecticides, prominently on the density and relative abundance of major prey groups like Collembola and Acari leading to notable decline in prey-predator ratio. Comparison of the percentage reductions of major taxonomic and trophic groups between pre-treatment and post-treatment intervals also demonstrated the ill effect of both heptachlor and endosulfan, notably on Collembola and the prey category. In the laboratory the survival success and fecundity of Cyphoderus javanus (Collembola) and Archegozetes longisetosus (Acari) were compared by exposing freshly emerged adults to sub-lethal concentrations of heptachlor and endosulfan for varying durations. The untreated control sets recorded high fecundity for both C. javanus and A. longisetosus, but chronic toxicity of the insecticides on adults confined to the treated soil resulted into very low fecundity. Even short duration exposure to heptachlor and endosulfan treated soil for 24 or 72 hours only was found to delay the egg-laying and decrease the fecundity of both the species. It is concluded that population responses and reproductive sensitivity in non-target soil microarthropods are potential eco-toxicological parameters for detecting pesticide pollution in soil and for ecological health assessment since the results are based on the bioactivity of toxicants.

Polymorphism of HIV-1 gag (p17) gene from female sex workers in Calcutta, India

HIV-1 subtype C is the major subtype in India as evidenced from the analysis of specific regions within envelope and gag gene. The matrix protein (p17) of HIV-1 which is involved in several functions like the viral RNA transport, nuclear localization, assembly of pre-integration complex into host nucleus has been used to study the strain diversity among female sexworkers in Calcutta. The gene encoding for the HIV-1 matrix protein, p17 was amplified by nested polymerase chain reaction (PCR) from blood samples of HIV-1 seropositive female sex workers (FSW) in Calcutta, India. Genes of twenty-two samples were sequenced and the phylogenetic analysis with different global strains showed that the majority (seventeen) was clustered with Indian type C. A few samples were found to be close to other C subtypes isolated from South Africa, China and Myanmar. The comparison of Calcutta samples with the samples from other regions of India along with other non-asian subtype C sequences clearly revealed a different cluster of Indian sequences. The two samples, cal 242 and cal 709 was found to be the most divergent type and showed close relatedness with African C subtypes.

A new method for isolation of leukocytes from the peripheral blood of amphibians [Bufo himalayanus, (Gunther)] and study of their surface morphology by scanning electron microscopy

Using percoll as the density gradient, a new single step method to isolate leukocytes from the peripheral blood of amphibians (B. himalayanus) has been described. Isolated leukocytes were photographed under the scanning electron microscope and an attempt has been made to characterize the leukocyte population on the basis of surface morphology. Apart from regular blood cell types, B. himalayanus have slender, elongated and slightly curved leukocyte type cells in their peripheral blood. Such slender elongated cells were absent in the blood of a related species B. stomnaticus and hence could not be categorized under the known blood cell types.

Seasonal influence on the onset of idiopathic inflammatory myopathies in serologically defined groups

OBJECTIVE

To assess possible seasonal patterns in the onset of polymyositis (PM) and dermatomyositis (DM).

METHODS

The study group comprised 503 patients who met the criteria for probable or definite PM or DM and for whom detailed data on the time of myositis onset were available. Statistical analyses were performed using a Poisson model that assessed associations of ethnicity, sex, autoantibody presence, and month of onset of muscle weakness.

RESULTS

There were no significant seasonal patterns of disease onset in myositis patients as a whole or in the total PM or DM populations. Significant seasonal associations were present, however, in the serologically defined groups. In the 131 patients with antisynthetase autoantibodies who were categorized as non-black, myositis onset peaked in March-April (P = 0.03). Among the antisynthetase-positive patients, the association was predominantly in those with PM (n = 85; P = 0.05) and in men (n = 51; P = 0.042). Patients with anti-signal recognition particle autoantibodies, however, did not have a significant seasonal onset, which is in contrast to previous findings. Patients without myositis-specific autoantibodies showed a significant peak in summer, with myositis onset in June-July (n = 252; P = 0.03); this seasonal association was significant in women (n = 182; P = 0.005), whereas there was no seasonal pattern in men (P = 0.9).

CONCLUSION

These findings, in conjunction with other data, suggest that diverse environmental agents, acting upon different immunogenetic backgrounds, result in distinct immune responses and clinical syndromes in the idiopathic inflammatory myopathies. Our results emphasize the importance of considering more homogeneous disease groups, based on clinicopathologic features, immune responses, ethnicity, and sex, when attempting to decipher the pathogeneses of autoimmune disorders.

Possible roles and determinants of microchimerism in autoimmune and other disorders

Microchimerism is the presence of a low level of non-host stem cells or their progeny in an individual. The most common source of microchimerism is pregnancy. During pregnancy, bi-directional trafficking of hematopoietic cells occurs through the placenta and these microchimeric cells persist for decades after childbirth. A possible role of microchimerism in the pathogenesis of some (systemic sclerosis, systemic lupus erythematosus, primary biliary cirrhosis, autoimmune thyroid diseases and juvenile myositis) but not all autoimmune diseases has been suggested by recent studies. Contradictory reports exist regarding HLA allelic associations with persistent T lymphocyte microchimerism. Although much of the focus of past studies has been on microchimerism in the effector arm of the immune system, increasing evidence suggests that microchimeric cells may differentiate into many lineages in different tissues raising additional possible roles for these cells. The possibility of microchimerism in many organs should induce an exploration of how persistent mixtures of cells of different genetic backgrounds throughout the body may influence diverse physiologic processes during life. In the present review, we discuss possible influencing factors and roles of all forms of microchimerism in autoimmune and non-autoimmune diseases. A better understanding of the immune mechanisms, along with the identification of environmental and genetic risk factors, is crucial for further deciphering the many possible implications of maternal-fetal and fetal-maternal cell trafficking in health and disease.

Estimation of tear glucose level and its role as a prompt indicator of blood sugar level

Tear glucose level was measured by glucose oxidase method to determine the relationship between tear glucose and corresponding blood glucose levels in 200 patients. It was observed that this test had a definite value in finding the hyperglycaemics semiquantitatively.

MobiMine

This paper describes an experimental mobile data mining system that allows intelligent monitoring of time-critical financial data from a hand-held PDA. It presents the overall system architecture and the philosophy behind the design. It explores one particular aspect of the system---automated construction of personalized focus area that calls for user's attention. This module works using data mining techniques. The paper describes the data mining component of the system that employs a novel Fourier analysis-based approach to efficiently represent, visualize, and communicate decision trees over limited bandwidth wireless networks. The paper also discusses a quadratic programming-based personalization module that runs on the PDAs and the multi-media based user-interfaces. It reports experimental results using an ad hoc peer-to-peer IEEE 802.11 wireless network.

An unusual case of a retained metallic arrowhead in the orbit and sphenoidal sinus

A case of retained metallic arrowhead in orbit and sphenoidal sinus through an unusual route is reported. The eyeball was removed because of a possible risk of sympathetic ophthalmia.

Revolutions in ophthalmology

Cataract is the major cause of blindness worldwide. The transition of couching of cataract to most modem phaco-emulsification gained popularity with more scientific capsulorhexis. Ongoing research is taking place with laser technologies for removal of cataract. Surgery has an important role in advanced corneal diseases. Corneal transplantation is the most successful form. The refractive errors can be corrected by laser-assisted in-situ keratomileusis, intrastromal corneal rings and phacic intra-ocular lenses. Current research is going on to identify the gene responsible for glaucoma and once this is identified, medical therapy can be developed to control the disease. Thermocautery or photocoagulation and indenting the globe so as to bring the choroid nearer the break by scleral buckling forms the basis of modern surgery of retinal detachment. Vitreoretinal diseases, macular degeneration, diabetic retinopathy are no longer considered problematic. We are optimistic that more clinical breakthroughs are expected in the 21st century with new advances of ophthalmic researches.

Estimation of total collagen and types I and III collagen in canine rotator cuff tendons

The collagen composition of the supraspinatus, infraspinatus, and subscapularis tendons, which form part of the rotator cuff of the shoulder, was determined. Tendons were obtained from adult, male beagle dogs and total collagen was estimated by measurement of hydroxyproline. There was little variation in collagen content among the three major cuff tendons and the quantity approximated that cited in the literature for other tendons. However, the collagen content in the insertion zone of the supraspinatus tendon was significantly higher than in the tendon proper. NaCl fractionation of supraspinatus collagen indicated that type I was the predominant collagen but significant amounts of type III and possibly some type II and type V were also present. Interestingly, there appeared to be more type III collagen in the insertion zone than in the tendon proper, cyanogen bromide digestion and peptide mapping confirmed this finding. The differential collagen composition of the supraspinatus tendon may contribute to the high incidence of tear that is associated with this rotator cuff tendon.