Retrospective survival analysis of the use of uncemented modular tapered stems for revision in periprosthetic Vancouver B-type fractures. Is instability a threat to survival?

INTRODUCTION AND OBJECTIVES

Periprosthetic hip fractures show increasing incidence and complexity, representing a challenge for the surgeon. We aimed to evaluate the survival of uncemented modular tapered stems in the treatment of periprosthetic Vancouver B2 and B3 type fractures and review the main complications and factors associated with decreased survival.

MATERIALS AND METHODS

We performed a retrospective study of patients submitted to revision arthroplasty for treatment of periprosthetic femoral stem Vancouver B2 and B3 type fractures with an uncemented modular fluted tapered stem (MRP-Titan). Demographic and radiographic parameters were analyzed. The survival rate (free of reoperation) was calculated at 2- and 5-years using the Kaplan-Meier survivorship analysis.

RESULTS

Thirty-nine patients were included with a mean age of 73.5 years and a mean follow-up of 5 years. Arthroplasty survivorship at 2 years was 73.7% and at 5 years was 67.5% (mean 8.4 years; range 6.7-10.2). Survivorship was inferior in the patients with episodes of instability (mean 2.5 years; range 0-5.42) (p<0.001). At least one episode of instability occurred in 26.3% of patients and 60% of these patients had a femoral head size 32mm or lower. At least one episode of instability occurred in 71.4% of patients with a greater trochanter fracture (p=0.008). The consolidation rate was 90.6% and the mortality rate was 23.7%. In the group of patients that died, 55.6% were submitted to at least one revision surgery (p=0.044).

CONCLUSION

Survivorship of an uncemented modular stem (MRP-Titan) in revision for PHF is significantly reduced by episodes of instability.

Genomic and epidemiological insight of an outbreak of carbapenemase-producing Enterobacterales in a Portuguese hospital with the emergence of the new KPC-124

BACKGROUND

Carbapenemase-producing Enterobacterales (CPE) is an increasing problem in healthcare settings. This study aimed to identify the source of a CPE outbreak that occurred in 2022, in a tertiary hospital in the North of Portugal, to identify exposed patients, and to assess the risk of becoming CPE-positive following hospital admission.

METHODS

A multi-disciplinary investigation was conducted including descriptive, analytical, and molecular epidemiology, environmental screening, and assessment of infection control measures. Clinical and environmental isolates were analyzed using whole-genome sequencing and phylogenetic analysis. Additionally, a prospective observational cohort study was conducted to further investigate the risk factors associated with the emergence of new cases in cohorts of CPE-negative admitted patients.

RESULTS

We observed the presence of multispecies KPC-, IMP-, and/or NDM-producing isolates. Genetically indistinguishable clinical and environmental isolates were found on the same room/ward. The ST45 KPC-3-producing Klebsiella pneumoniae clone was the responsible for the outbreak. During patients' treatment, we detected the emergence of resistance to ceftazidime-avibactam, associated with mutations in the blaKPC-3 gene (blaKPC-46, blaKPC-66 and blaKPC-124, the last variant never previously reported), suggesting a vertical evolutionary trajectory. Patients aged ≥ 75 years, hygiene/feeding-care dependent, and/or subjected to secretion aspiration were risk factors for CPE colonization after hospital admission. Additionally, cases with previous admission to the emergency department suggest that CPE dissemination may occur not only during hospitalization but also in the emergency department.

CONCLUSION

Overall, the study highlights that selection pressure with antibiotics, like ceftazidime-avibactam, is a contributing factor to the emergence of new β-lactamase variants and antibiotic resistance. It also shows that the hospital environment can be a significant source of CPE transmission, and that routine use of infection control measures and real-time molecular epidemiology investigations are essential to ensure the long-term termination of CPE outbreaks and prevent future resurgences.

Bursaphelenchus mucronatus (Nematoda: Parasitaphelenchidae) associated with Monochamus galloprovincialis from Bosnia and Herzegovina and Georgia

Bursaphelenchus mucronatus was detected in association with the pine sawyer beetle (Monochamus galloprovincialis) during the implementation and testing of cross traps with insect attractants as an efficient tool for detection survey for pine wood nematode (Bursaphelenchus xylophilus) in Bosnia and Herzegovina and Georgia in 2017 and 2018, respectively. This nematode was characterized by morphological, morphometric and molecular features. This is the first report of B. mucronatus in association with a M. galloprovincialis in Bosnia and Herzegovina and in Georgia.

A chemical study of yoghurt produced under isostatic pressure during storage

Yoghurt fermented under sub-lethal high pressure (10, 20, 30 and 40 MPa at 43 °C), and afterward placed under refrigeration (4 °C for 23 days) was studied and compared with yoghurt fermented at atmospheric pressure (0.1 MPa). For a deeper analysis, metabolite fingerprinting by nuclear magnetic resonance (NMR), sugars and organic acids assessment by high performance liquid chromatography (HPLC), total fatty acids (TFA) determination and quantification by gas chromatography with a flame ionization detector (GC-FID) were performed. Metabolomic analyses revealed that only 2,3-butanediol, acetoin, diacetyl and formate vary with the increase of pressure and probable relation with pressure influenced diacetyl reductase, acetoin reductase and acetolactate decarboxylase. Yoghurts fermented at 40 MPa had the lowest content in lactose (39.7 % of total sugar reduction) and the less content in TFA (56.1 %). Further research is of interest to understand more about fermentation processes under sub-lethal high pressure.

MINIATURIZED LIQUID-LIQUID EXTRACTION WITH LOW-TEMPERATURE PARTITIONING TECHNIQUE (LLE/LTP) FOR PESTICIDE ANALYSIS IN A BIOLOGICAL MATRIX BY GAS CHROMATOGRAPHY

The liquid-liquid extraction with low-temperature partitioning technique (LLE/LTP) was miniaturized to determine the pesticides chlorpyrifos, bifenthrin, λ-cyhalothrin, and deltamethrin in a biological matrix, by gas chromatography. The method was proposed for fetal-bovine serum samples (500 μL), by using a full factorial design (23) with one center point. The evaluated factors included the volume of water added to the sample (1000 μL), volume of extraction solvent (500 μL) and stirring time (60 s) – a cleanup step was not necessary. The method was validated for the main figures of merit. The results indicated that the LLE/LTP/GC/ECD miniaturized method was efficient in extracting pesticides from blood-serum samples (75 to 115%). It showed both selectivity and sensitiveness, with limits of quantification (LOQ) ranging from 8 at 17 μg L-1. Once validated, the method was applied to blood-serum samples of rural workers from a city in the Brazilian state of Minas Gerais. In that case, the presence of chlorpyrifos was detected in two of the samples.

Additional notes on the morphology and molecular data of the Kikuyu root-knot nematode, Meloidogyne kikuyensis (Nematoda: Meloidogynidae)

Females, males, and second-stage juveniles of Meloidogyne kikuyensis were examined by light and scanning electron microscopy. The morphology of M. kikuyensis was typical for species of the genus in general, but differed in several characters, appearing to be in a more primitive state. The head morphology of males and second-stage juveniles of most species of root-knot nematode is made up of a large labial disk surrounded by the fused pairs of the sub-dorsal and sub-ventral lips, but in M. kikuyensis, the labial disk is surrounded by six distinct lips. Second-stage juveniles appear to develop similarly to that of other members of the genus. The division of the egg seems to be quite different from typical species in that two small, highly refractive cells, are set-aside early in embryogenesis. Elucidation of the mitochondrial nucleotide sequence for the cytochrome oxidase subunit II and the large subunit of the ribosomal RNA gene (COII-16S rRNA) and the ITS1 region implicated M. kikuyensis is in a basal position when compared to other species of the genus.

Blueberries effects in experimental diet-induced prediabetes: a focus on renal impairment

Introduction Benefits arising from blueberry (BB) consumption are well-described in type 2 diabetes evolution and inherent complications. Lending further support to this thesis, previous work from our group unequivocally demonstrates BB supplementation efficacy to manage prediabetic hepatic liver steatosis. Whether a similar effect also holds truth in early renal impairment is an unsolved issue.

Objectives To address blueberry juice (BJ) ability to exert renoprotective effects in experimental prediabetes.

Methodology Diet-induced prediabetes [high-sucrose (35% Hsu) and high-fat (60% HF)] was developed in adult male Wistar rats through the ingestion of HSu for 9 weeks supplemented by HF for another 14 weeks (HSuHF, n = 16). On W9, half of the former animals orally received BJ (25g/kg BW, HSuHF+BJ). Control animals (n = 8) received standard diet during the entire protocol. Functional [serum and urinary creatinine, uric acid, glucose; glomerular filtration rate (GFR)], structural [H&E and Oil Red O staining] and molecular [triglycerides content and inflammation (RT-qPCR, WB)] markers of renal injury were assessed along with metabolic profile.

Results Even though diet-induced glucose intolerance, insulin insensitivity and plasmatic hypertriglyceridemia were significantly ameliorated upon BJ treatment, this nutraceutical intervention was unable to halt or slow down renal lipidosis and glomerular crescent-like lesions apart from a slight amelioration of both GFR and IL-6 levels in HSuHF-treated rats.

Conclusion Unlike previous results clearly demonstrating the ability of BJ nutraceutical intervention to afford protection against metabolic impairment and hepatic steatosis evolution in experimentally diet-induced prediabetes, only a modest renoprotective effect was observed in functional and morphological renal endpoints. Future studies are warranted to dissect the divergent effects of BJ on early liver and kidney impairment.

Meloidogyne aegracyperi n. sp. (Nematoda: Meloidogynidae), a root-knot nematode parasitizing yellow and purple nutsedge in New Mexico

Meloidogyne aegracyperi n. sp. is described from roots of purple nutsedge in southern New Mexico, USA. Mature females are small (310–460 µm), pearly white, with their egg masses completely contained inside root galls. The neck is often at a 90 to 130° angle to the protruding posterior end with the perineal pattern. The distance of the dorsal esophageal gland orifice (DGO) to the base of the stylet is relatively long (4.0–6.1 µm), and the excretory pore is level with the base of the stylet. The anterior portion of the rounded lumen lining of the metacorpus contains 3 to 10 small vesicles. The perineal pattern has a rounded dorsal arch with a tail terminal area that is smooth or marked with rope-like striae. Only two males were found. The body twists 90° throughout its length. The DGO to the base of the stylet is long (3.0–3.3) µm. The cephalic framework of the second-stage juvenile is weak, and the stylet is short (10.1–11.8 µm). The DGO to the base of the stylet is long (3–5 µm). The tail is very long (64–89 µm) and the hyaline portion of the tail is very narrow, making the tail finely pointed. Eggs are typical for the genus and vary in length (85.2–99.8 µm) and width (37.1–48.1 µm), having a L/W ratio of (2.1–2.6). Maximum likelihood phylogenetic analyses of the different molecular loci (partial 18S rRNA, D2-D3 of 28S rRNA, internal transcribed spacer (ITS) rRNA, cytochrome oxidase subunit II (COII)-16S rRNA of mitochondrial DNA gene fragments and partial Hsp90 gene) placed this nematode on an independent branch in between M. graminicola and M. naasi and a cluster of species containing M. chitwoodi. M. fallax, and M. minor. Greenhouse tests showed that yellow and purple nutsedge were the best hosts, but perennial ryegrass, wheat, bentgrass, and barley were also hosts.

Conversion From Twice-Daily to Once-Daily Tacrolimus in Stable Kidney Graft Recipients

INTRODUCTION

Immunosuppression has a pivotal role in kidney transplantation. The new prolonged-release formulation of tacrolimus was developed to provide a more convenient once-daily dosing to improve patient adherence.

METHODS

We selected 60 stable kidney transplant recipients who underwent tacrolimus conversion in our unit. Conversion was made on a 1 mg:1 mg basis in 66.7% of patients (n = 40) and on a 1 mg:1.1 mg basis in the remaining 33.3% (n = 20). Clinical and analytical data at conversion and postconversion was analyzed retrospectively to evaluate the efficacy and safety of conversion from tacrolimus twice-daily to once-daily formulation.

RESULTS

A significant reduction in tacrolimus blood levels requiring an increase in tacrolimus daily dose was observed postconversion. Postconversion tacrolimus blood level reduction >25% was significantly higher in the conversion group 1 mg:1 mg basis (P = .004). In patients converted 1 mg:1 mg, female sex and higher tacrolimus level at conversion were significant risk factors for a reduction >25% in tacrolimus blood levels after conversion. No significant change was detected between mean glomerular filtration rate at conversion (57 mL/min) and at 3, 6, and 9 months postconversion.

CONCLUSIONS

Once-daily tacrolimus at similar doses to the twice-daily formulation is an efficient and safe treatment option. Conversion made on 1 mg:1.1 mg basis seems advantageous at least in some patients.

Nematicidal activity of essential oils and volatiles derived from Portuguese aromatic flora against the pinewood nematode, Bursaphelenchus xylophilus

Twenty seven essential oils, isolated from plants representing 11 families of Portuguese flora, were screened for their nematicidal activity against the pinewood nematode (PWN), Bursaphelenchus xylophilus. The essential oils were isolated by hydrodistillation and the volatiles by distillation-extraction, and both were analysed by GC and GC-MS. High nematicidal activity was achieved with essential oils from Chamaespartium tridentatum, Origanum vulgare, Satureja montana, Thymbra capitata, and Thymus caespititius. All of these essential oils had an estimated minimum inhibitory concentration ranging between 0.097 and 0.374 mg/ml and a lethal concentration necessary to kill 100% of the population (LC(100)) between 0.858 and 1.984 mg/ml. Good nematicidal activity was also obtained with the essential oil from Cymbopogon citratus. The dominant components of the effective oils were 1-octen-3-ol (9%), n-nonanal, and linalool (both 7%) in C. tridentatum, geranial (43%), neral (29%), and β-myrcene (25%) in C. citratus, carvacrol (36% and 39%), γ-terpinene (24% and 40%), and p-cymene (14% and 7%) in O. vulgare and S. montana, respectively, and carvacrol (75% and 65%, respectively) in T. capitata and T. caespititius. The other essential oils obtained from Portuguese flora yielded weak or no activity. Five essential oils with nematicidal activity against PWN are reported for the first time.

Internalization of glial cell-derived neurotrophic factor receptor GFR alpha 1 in the absence of the ret tyrosine kinase coreceptor

1. Glial cell-derived neurothrophic factor (GDNF) interacts with a cell surface receptor, GFRalpha1, that is linked via a glycosyl-phosphatidylinositol (GPI) lipid to the cell membrane. The neurotrophic activities of GDNF are mediated by binding to GFRalpha1 and further interaction of the GDNF-GFRalpha1 complex with a coreceptor tyrosine kinase encoded by the c-Ret protooncogene. There is also evidence for the existence of cell signaling by GDNF and GFRalpha1 in the absence of Ret. 2. To further delineate the Ret-dependent and -independent functions of GDNF, cellular internalization of GDNF and GFRalpha1 was examined in cells lines and primary neurons. 3. Relative to other GPI-anchored receptors, efficient endocytosis (approximately 30-40% of total surface-bound ligand internalized after 2 min) of GNDF and GFRalpha1 was observed in neuroblastoma and transfected-fibroblast cell lines that lack Ret. Primary hippocampal neurons from transgenic mice that express a wild-type GFRalpha1 together with a mutant, tyrosine kinase-inactive Ret also internalized GDNF efficiently (approximately 20% of total surface-bound ligand internalized after 2 min). We also observed a ligand dependence for GFRalpha1 internalization in the cell lines that lack Ret. Furthermore, a comparison in the presence and absence of Ret indicates that this coreceptor tyrosine kinase slows internalization at early time points. 4. The data suggest different mechanisms of internalization for GDNF-GFRalpha1 in the absence and presence of the Ret coreceptor.

True colour imaging of the fundus using a scanning laser ophthalmoscope

Currently retinal imaging is performed with the fundus camera. This has a number of limitations, in particular the high level of illuminations required for imaging. The scanning laser ophthalmoscope (SLO) has been proposed as an alternative imaging device but to date one of its main limitations has been that it gives only monochromatic images. In this paper we describe an SLO which uses low power red, green and blue lasers to image the human fundus. Using three lasers simultaneously to produce a colour image will increase the fundus exposure by a factor of three. To overcome this problem, a technique has been developed for multiplexing the lasers so that each point on the retina is imaged by the three lasers pulsed rapidly in sequence. The total exposure is thus kept to the same level as for a single laser and total imaging time is not increased. An example is shown of the image from a patient with diabetic retinopathy.

Local administration of morphine for analgesia after iliac bone graft harvest

BACKGROUND

Harvesting autogenous bone grafts from the ilium may cause considerable pain and may represent a significant source of postoperative morbidity. The local application of morphine can reduce pain in a rat model of bone damage. We evaluated the analgesic efficacy of administering morphine to the donor bone graft site for spinal fusionsurgery.

METHODS

Sixty patients undergoing cervical spinal fusion surgery using autogenous bone harvested from the ilium were randomly assigned to one of three groups: Group 1 was given saline infiltrated into the harvest site, group 2 was given 5 mg intramuscular morphine; group 3 was given 5 mg morphine infiltrated into the harvest site. After surgery, all patients were given morphine through a patient-controlled analgesia pump. Pain scores both from the harvest and the incision sites, as well as morphine use, were recorded at 2, 4, 6, 8, 12, and 24 h after surgery. At 1 yr after surgery the presence and subjective characteristics of donor site pain were recorded.

RESULTS

Total 24-h morphine use (milligrams) was significantly lower (P < 0.0001) in group 3 (33.7+/-8.3 mg, mean +/- SD), compared with either group 1 (64.3+/-6.6 mg) or group 2 (59.6+/-9.3 mg). Pain from the graft site was scored the same at 2 h but remained significantly lower (P < 0.0001) for group 3 at all later time intervals. Pain scores from the incision site were similar among the three study groups. One year after surgery, 25% of patients reported having chronic donor site pain. The association of chronic donor site pain was significantly higher (P < 0.05) in groups 1 (33%) and 2 (37%) compared with group 3 (5%).

CONCLUSION

Low-dose morphine applied to the harvest graft site can reduce local pain, morphine use, and chronic donor site pain after cervical spine fusion surgery.

Clinical investigation of a true color scanning laser ophthalmoscope

OBJECTIVE

To show true color scanning laser ophthalmoscope (SLO) images produced by simultaneously imaging the retina with red, green, and blue lasers.

METHODS

Low-power red, green, and blue lasers were combined using fiber optics. By rapidly pulsing the lasers, each point on the fundus is illuminated by the 3 colors in quick succession, with the total power level being similar to that from a single laser. The reflected light is then decoded to extract the red, green, and blue color information and the true color fundus image is displayed live on a computer monitor.

RESULTS

Comparison was made between the color SLO images from 5 patients and their digitized fundus photographs. The background fundus and retinal vasculature showed a similar appearance. The SLO gave better quality information in patients with ocular histoplasmosis, macular dystrophy, and optic disc drusen. By operating the color SLO in the indirect mode, macular edema could be clearly seen as lines and ridges surrounding the fovea.

CONCLUSION

The color SLO offers all the advantages of the present commercially available monochromatic device, with the added advantage of true color representation of the fundus without increasing either imaging time or the level of exposure.

Tomographic reconstruction of the retina using a confocal scanning laser ophthalmoscope

Retinal imaging with a confocal scanning laser ophthalmoscope (cSLO) involves scanning a small laser beam over the retina and constructing an image from the reflected light. By applying the confocal principle, tomographic images can be produced. However, the thickness of such slices, when compared with the retinal thickness, is too large to give useful 3D retinal images. In this study an algorithm has been developed which fits a double Gaussian curve to the axial intensity profiles generated from a stack of image slices. The underlying assumption is that the laser light has mainly been reflected by two structures in the retina, the internal limiting membrane and the retinal pigment epithelium. From the fitted curve, topographic images and novel thickness images of the retina can be generated. The technique has been applied to three normal volunteers and seven patients with macular pathology (cystoid macular oedema and macular hole) demonstrating the clinical value of the technique. The improvement in accuracy achieved by using a double rather than a single Gaussian is also demonstrated.

In vivo cell tracking by scanning laser ophthalmoscopy: quantification of leukocyte kinetics

PURPOSE

To image peripheral blood leukocyte traffic in the normal retinal and choroidal vasculature and to quantify the differences in the circulation dynamics between normal and concanavalin A (ConA)-activated leukocytes.

METHODS

Normal or ConA-activated splenocytes were fluorescently labeled in vitro with 6-carboxyfluorescein diacetate (CFDA) and reinfused in vivo where they were tracked in the retinal and choroidal circulations of syngeneic rats by means of a scanning laser ophthalmoscope (SLO). Simultaneous digital and video images were captured for as long as 30 minutes, and the initial 15 seconds of image sequences and leukocyte dynamics were analyzed from digitized images by recording the velocity of trafficking cells and the number of stationary cells that accumulated with time, using a customized software package.

RESULTS

Mean velocity (+/-SD) was 29.8 +/- 15.3 mm/sec in the retinal arteries, 14.7 +/- 7.2 mm/sec in the retinal veins, and 3.0 +/- 3.6 mm/sec in the retinal capillaries. Mean velocity in the choroidal vessels was 6.1 +/- 6.0 mm/sec. No significant difference in leukocyte velocity was found between activated and normal leukocytes in any of the vessel systems. However, activated leukocytes were observed to accumulate more within the choroidal vasculature (P < 0.001) and the retinal capillaries (P < 0.001) than in control animals, but not in larger retinal vessels.

CONCLUSIONS

A technique to measure the kinetics of circulating leukocytes in vivo has been developed. Although leukocyte activation itself is insufficient to cause slowing of leukocyte velocity, the data indicate that leukocyte adherence to endothelium can be induced in the absence of local or systemic activating stimuli.

Quantifying changes in retinal circulation: the generation of parametric images from fluorescein angiograms

Fluorescein angiography is an established technique for examining the functional integrity of the retinal circulation. The ability to quantify this function offers the possibility of early detection of changes due to retinopathy. We have developed a technique to generate functional, parametric images of the retinal circulation. A given angiogram is first registered to align consecutive frames. At each point in the retina, a graph of fluorescein intensity versus time is then constructed and fitted with a gamma variate curve. Parameters are extracted from these curves and formed into parametric images showing the variation in fluorescein passage across the entire area of the angiogram. Parameters examined to date include time to maximum intensity, time of arrival and rise time. The technique has been demonstrated using photographic and scanning laser ophthalmoscopic angiograms of both normal subjects and patients with a variety of retinopathies. The time to maximum images of the normal subjects reveals a similar fillings pattern in each case, whilst the pathologies present in the abnormal angiograms are clearly identified. The generation of functional time to maximum images enables the health of the retinal circulation to be quantified with respect to the rate at which the vasculature fills with fluorescein. This offers a potential tool for detecting the onset of retinopathy and monitoring its progression.

Acute gastric volvulus and congenital posterolateral diaphragmatic hernia

Acute gastric volvulus in infancy is a rare disorder and a surgical emergency. Prompt clinical suspicion and radiological assessment are essential for this life-threatening condition. We report a 3-month-old female case, admitted for an initial suspicion of an intestinal obstruction. She presented unproductive retching, respiratory distress, epigastric distension and lethargy. It was not possible to introduce a naso-gastric tube. A radiological contrast study showed an occluded cardio-esophageal junction without passage of barium, two gastric fluid levels and a horizontally positioned stomach occupying the inferior portion of the left hemithorax, suggesting a left diaphragmatic hernia. Laparotomy revealed an acute mesenterico-axial gastric volvulus with a left posterolateral diaphragmatic hernia. The stomach volvulus was untwisted, the diaphragmatic defect was repaired after reduction of the herniated contents and no gastropexy was done. At 3 and 6-months follow-up examination the infant was asymptomatic and thriving.

Dendritic cells produce IL-12 and direct the development of Th1 cells from naive CD4+ T cells

Dendritic cells are APCs that are unique in their potency to stimulate proliferation of primary Ag-specific responses in vitro and in vivo. In this study, we demonstrate that dendritic cells can produce IL-12, a dominant cytokine involved in the development of IFN-gamma-producing T cells. This finding resulted from our observations that dendritic cell-induced Th1 development from total CD4+ T cells upon neutralization of endogenous levels of IL-4 was IL-12-dependent. Furthermore, we demonstrate that dendritic cells can induce the development of Th1 cells from Ag-specific naive LECAM-1bright CD4+ T cells obtained from alpha beta-TCR transgenic mice, provided that CD4+ LECAM-1dull T cells, which produce significant levels of IL-4, are not present in the primary cultures. Production of IL-12 by dendritic cells was confirmed by positive immunofluoresence staining with Abs specific for the inducible IL-12 p40 subunit. This suggests that in addition to inducing proliferation and clonal expansion of naive T cells, dendritic cells, by their production of IL-12, play a direct role in the development of IFN-gamma-producing cells that are important for cell-mediated immune responses.

Dendritic cells produce IL-12 and direct the development of Th1 cells from naive CD4+ T cells

Dendritic cells are APCs that are unique in their potency to stimulate proliferation of primary Ag-specific responses in vitro and in vivo. In this study, we demonstrate that dendritic cells can produce IL-12, a dominant cytokine involved in the development of IFN-gamma-producing T cells. This finding resulted from our observations that dendritic cell-induced Th1 development from total CD4+ T cells upon neutralization of endogenous levels of IL-4 was IL-12-dependent. Furthermore, we demonstrate that dendritic cells can induce the development of Th1 cells from Ag-specific naive LECAM-1bright CD4+ T cells obtained from alpha beta-TCR transgenic mice, provided that CD4+ LECAM-1dull T cells, which produce significant levels of IL-4, are not present in the primary cultures. Production of IL-12 by dendritic cells was confirmed by positive immunofluoresence staining with Abs specific for the inducible IL-12 p40 subunit. This suggests that in addition to inducing proliferation and clonal expansion of naive T cells, dendritic cells, by their production of IL-12, play a direct role in the development of IFN-gamma-producing cells that are important for cell-mediated immune responses.

Lymphopenia in interleukin (IL)-7 gene-deleted mice identifies IL-7 as a nonredundant cytokine

Interleukin (IL)-7 is a potent stimulus for immature T and B cells and, to a lesser extent, mature T cells. We have inactivated the IL-7 gene in the mouse germline by using gene-targeting techniques to further understand the biology of IL-7. Mutant mice were highly lymphopenic in the peripheral blood and lymphoid organs. Bone marrow B lymphopoiesis was blocked at the transition from pro-B to pre-B cells. Thymic cellularity was reduced 20-fold, but retained normal distribution of CD4 and CD8. Splenic T cellularity was reduced 10-fold. Splenic B cells, also reduced in number, showed an abnormal population of immature B cells in adult animals. The remaining splenic populations of lymphocytes showed normal responsiveness to mitogenic stimuli. These data show that proper T and B cell development is dependent on IL-7. The IL-7-deficient mice are the first example of single cytokine-deficient mice that exhibit severe lymphoid abnormalities.

Interleukin-10

In the three years since its discovery, the pleiotropic cytokine interleukin-10 (IL-10) has been implicated as an important regulator of the functions of lymphoid and myeloid cells. IL-10's ability to block activation of cytokine synthesis and several accessory cell functions of macrophage renders this cytokine a potent suppressor of the effector functions of macrophages, T cells, and NK cells. In addition, IL-10 likely contributes to regulating proliferation and differentiation of B cells, mast cells, and thymocytes. The Epstein-Barr virus genome encodes a homolog of IL-10 (BCFR1, viral IL-10, vIL-10) which shares many of the cellular cytokine's biological activities and may therefore play a role in the host-virus interaction. This article reviews current studies of IL-10's biological activities and discusses its possible roles in regulation of immune responses.

Interleukin-10

In the three years since its discovery, the pleiotropic cytokine interleukin-10 (IL-10) has been implicated as an important regulator of the functions of lymphoid and myeloid cells. IL-10's ability to block activation of cytokine synthesis and several accessory cell functions of macrophage renders this cytokine a potent suppressor of the effector functions of macrophages, T cells, and NK cells. In addition, IL-10 likely contributes to regulating proliferation and differentiation of B cells, mast cells, and thymocytes. The Epstein-Barr virus genome encodes a homolog of IL-10 (BCFR1, viral IL-10, vIL-10) which shares many of the cellular cytokine's biological activities and may therefore play a role in the host-virus interaction. This article reviews current studies of IL-10's biological activities and discusses its possible roles in regulation of immune responses.

Polymerase chain reaction for detection of cytokine gene expression

A powerful method to amplify reverse-transcribed RNA, the polymerase chain reaction can be used to measure cytokine gene transcription in a small number of cells, or in cases where there is low mRNA copy number. This technique may be used to obtain qualitative or quantitative determinations of cytokine gene expression. In this review we discuss the various strategies recently described for the evaluation of cytokine expression using the polymerase chain reaction.

IL-10 acts on the antigen-presenting cell to inhibit cytokine production by Th1 cells

Murine IL-10 (cytokine synthesis inhibitory factor) inhibits cytokine production by Th1 cell clones when they are activated under conditions requiring the presence of APC. By preincubating APC with IL-10, we demonstrate that IL-10 acts principally on APC to inhibit IFN-gamma production by Th1 clones. Moreover, IL-10 is not active when Th1 cells are stimulated with glutaraldehyde-fixed APC, which also indicates that its action involves regulation of APC function. Furthermore, IL-10 inhibits cytokine synthesis by Th1 cells stimulated with the super-antigen Staphylococcus enterotoxin B, which does not appear to require processing. Flow microfluorimetry purified splenic or peritoneal B cells and macrophages, and B cell and macrophage cell lines can present Ag to Th1 clones. However, IL-10 acts only on sorted macrophages and the macrophage cell line to suppress IFN-gamma production by Th1 clones. IL-10 does not show this effect when B cells are used as APC. In contrast, IL-10 does not impair the ability of APC to stimulate cytokine production by Th2 cells. IL-10 does not decrease IFN-gamma-induced I-Ad levels on a macrophage cell line. Inasmuch as IL-10 also inhibits IL-2-induced IFN-gamma production by Th1 cells in an Ag-free system requiring only the presence of accessory cells, these data suggest that IL-10 may inhibit macrophage accessory cell function which is independent of TCR-class II MHC interactions.

IL-10 acts on the antigen-presenting cell to inhibit cytokine production by Th1 cells

Murine IL-10 (cytokine synthesis inhibitory factor) inhibits cytokine production by Th1 cell clones when they are activated under conditions requiring the presence of APC. By preincubating APC with IL-10, we demonstrate that IL-10 acts principally on APC to inhibit IFN-gamma production by Th1 clones. Moreover, IL-10 is not active when Th1 cells are stimulated with glutaraldehyde-fixed APC, which also indicates that its action involves regulation of APC function. Furthermore, IL-10 inhibits cytokine synthesis by Th1 cells stimulated with the super-antigen Staphylococcus enterotoxin B, which does not appear to require processing. Flow microfluorimetry purified splenic or peritoneal B cells and macrophages, and B cell and macrophage cell lines can present Ag to Th1 clones. However, IL-10 acts only on sorted macrophages and the macrophage cell line to suppress IFN-gamma production by Th1 clones. IL-10 does not show this effect when B cells are used as APC. In contrast, IL-10 does not impair the ability of APC to stimulate cytokine production by Th2 cells. IL-10 does not decrease IFN-gamma-induced I-Ad levels on a macrophage cell line. Inasmuch as IL-10 also inhibits IL-2-induced IFN-gamma production by Th1 cells in an Ag-free system requiring only the presence of accessory cells, these data suggest that IL-10 may inhibit macrophage accessory cell function which is independent of TCR-class II MHC interactions.

Isolation and expression of human cytokine synthesis inhibitory factor cDNA clones: homology to Epstein-Barr virus open reading frame BCRFI

We have demonstrated the existence of human cytokine synthesis inhibitory factor (CSIF) [interleukin 10 (IL-10)]. cDNA clones encoding human IL-10 (hIL-10) were isolated from a tetanus toxin-specific human T-cell clone. Like mouse IL-10, hIL-10 exhibits strong DNA and amino acid sequence homology to an open reading frame in the Epstein-Barr virus, BCRFI. hIL-10 and the BCRFI product inhibit cytokine synthesis by activated human peripheral blood mononuclear cells and by a mouse Th1 clone. Both hIL-10 and mouse IL-10 sustain the viability of a mouse mast cell line in culture, but BCRFI lacks comparable activity in this assay, suggesting that BCRFI may have conserved only a subset of hIL-10 activities.

Expression of interleukin-10 activity by Epstein-Barr virus protein BCRF1

Cytokine synthesis inhibitory factor (CSIF; interleukin-10), a product of mouse TH2 T cell clones that inhibits synthesis of cytokines by mouse TH1 T cell clones, exhibits extensive sequence similarity to an uncharacterized open reading frame in the Epstein-Barr virus BCRF1. Recombinant BCRF1 protein mimics the activity of interleukin-10, suggesting that BCRF1 may have a role in the interaction of the virus with the host's immune system.

Homology of cytokine synthesis inhibitory factor (IL-10) to the Epstein-Barr virus gene BCRFI

Complementary DNA clones encoding mouse cytokine synthesis inhibitory factor (CSIF; interleukin-10), which inhibits cytokine synthesis by TH1 helper T cells, were isolated and expressed. The predicted protein sequence shows extensive homology with an uncharacterized open reading frame, BCRFI, in the Epstein-Barr virus genome, suggesting the possibility that this herpes virus exploits the biological activity of a captured cytokine gene to enhance its survival in the host.

Homology of cytokine synthesis inhibitory factor (IL-10) to the Epstein-Barr virus gene BCRFI

Complementary DNA clones encoding mouse cytokine synthesis inhibitory factor (CSIF; interleukin-10), which inhibits cytokine synthesis by TH1 helper T cells, were isolated and expressed. The predicted protein sequence shows extensive homology with an uncharacterized open reading frame, BCRFI, in the Epstein-Barr virus genome, suggesting the possibility that this herpes virus exploits the biological activity of a captured cytokine gene to enhance its survival in the host.

Persistence of memory B cells in mice deprived of T cell help

The influence of T cell help on the induction, maintenance, and recall of B cell memory to a T cell-dependent antigen was studied in mice. The antigen was a hapten coupled to a protein carrier, and helper T cells were eliminated before, during, or after immunization by treatment of the animals with anti-CD4 antibodies. B cell memory was quantified in an adoptive cell transfer system, transferring B cells from the primed animals together with carrier-primed syngeneic T cells. Anti-CD4 treatment completely inhibited the induction of primary and secondary responses and of B cell memory. In contrast, it did not affect established B cell memory over a period of at least 6 weeks. Consequently, this suggests that within this time range B cell memory to a T cell-dependent antigen does not rely on the continuous recruitment of naive B cells into the memory compartment, and memory B cells need little or no (antigen-mediated) T cell help in order to persist.