E3 ubiquitin ligase CBLB regulates innate immune responses and bacterial dissemination during nontuberculous mycobacteria infection

Nontuberculous Mycobacteria (NTM) are emerging opportunistic pathogens causing pulmonary infection to fatal disseminated disease. NTM infections are steadily increasing in children and adults, and immune-compromised individuals are at a greater risk of fatal infections. The NTM disease's adverse pathology and the drug resistance to antibiotics have further worsened the therapeutic measures. Innate immune regulators are potential targets for therapeutics to NTM, especially in T cell suppressed population and many ubiquitin ligases modulate pathogenesis and innate immunity during infections, including mycobacterial infections. Here, we investigated the role of an E3 ubiquitin ligase, Casitas B-lineage lymphoma proto-oncogene B (CBLB), in immunocompromised mouse models of NTM infection. We found that CBLB is essential to prevent bacterial growth and dissemination. Cblb-deficiency debilitated NK cells, inflammatory monocytes, and macrophages in vivo. However, Cblb-deficiency in macrophages did not wane its ability to inhibit bacterial growth or production of reactive oxygen species nor the IFNγ production by NK cells in vitro. CBLB restricted the NTM growth and dissemination by promoting early granuloma formation in vivo. Our study shows that CBLB bolsters innate immune responses and helps prevent the dissemination of NTM during compromised T-cell immunity.

Metabolically active angiosperms survive passage through the digestive tract of a large-bodied waterbird

Avian vectors, such as ducks, swans and geese, are important dispersers of plant propagules. Until recently, it was thought that small vegetative propagules were reliant on adherence to vectors and are unlikely to survive passage through the avian digestive tract. Here, we conclusively demonstrate that metabolically active angiosperms can survive passage through the digestive tract of a large-bodied waterbird. In addition, we show that extended periods of air exposure for up to 7 days does not inhibit the survival of plantlets embedded in faecal matter. Following air exposure, plantlets (n = 3000) were recovered from 75 faecal samples of mute swans, Cygnus olor, with the survival of 203 plantlets. The number of recovered and surviving plantlets did not significantly differ among durations of air exposure. For recovered plantlets, the long-term viability and clonal reproduction of two duckweed species, Lemna minor and L. gibba, were confirmed following greater than eight months of growth. These data further amplify the key role of waterbirds as vectors for aquatic plant dispersal and demonstrate the internal transport (i.e. endozoochory) of metabolically active plantlets. These data suggest dispersal of vegetative plant propagules by avian vectors is likely to be a common occurrence, underpinning connectivity, range expansion and invasions of some aquatic plants.

Uncovering the role of CBLB for innate immune responses regulating systemic dissemination during a Non-Tuberculous Mycobacterial infection

Non-Tuberculous Mycobacteria (NTM) are ubiquitous and cause chronic lung infections to fatal disseminated diseases in immunocompromised individuals. The incidence and prevalence of NTM infections are increasing globally, mainly due to the surging numbers of immunocompromised patients. The diagnosis is often misleading, and the emergence of multi-drug resistant NTM has deprived the treatment options. Innate immune responses, dictated by immune regulators, shape the clinical outcomes of NTM infections. Here, we describe the role of an E3 ubiquitin ligase, CBLB, for innate immunity against an NTM infection. We found that the absence of CBLB, under T-cell deficiency, enhanced the bacterial burden and dissemination following both intravenous and intratracheal infections. Strikingly, CBLB fostered an early induction of granulomatous inflammation, which thwarts the dissemination. CBLB-deficiency caused a significant reduction of NK cell numbers, but not their intrinsic functions. Further, we found that CBLB was required to augment the numbers of inflammatory monocytes and conventional dendritic cells, the latter, additionally, for their activation. Thus, our findings suggest that CBLB plays an essential role in eliciting protective innate immune responses to control the growth and dissemination of NTM during T-cell deficiency.

Ingestion of anthropogenic debris by migratory barnacle geese Branta leucopsis on a remote north-eastern Atlantic island

Although seabirds are frequently used as sentinel species for anthropogenic pollution, the extent and impacts of synthetic debris ingestion remains poorly studied for many water bird species. Here, we assess ingestion of synthetic particles (≥0.5 mm) by barnacle geese, Branta leucopsis, wintering on a remote island. Faecal samples were collected over a period of four wintering seasons. In total, 71 individual samples were assessed, with 79% of samples displaying at least one debris particle (maximum lengths 0.5-5 mm) from anthropogenic sources. The recovered synthetic debris were identified as micro-fibres (n = 166) and micro-fragments (n = 165). The number of synthetic particles detected per sample was generally low at 4.7 ± 0.9, 43 (mean ± SE, maximum): micro-fibres 2.3 ± 0.3, 10; micro-fragments 2.3 ± 0.8, 40. Particle numbers detected per gram of faecal sample differed amongst wintering seasons. Our results suggest that non-marine water birds can frequently ingest low quantities of synthetic particles in remote coastal habitats.

Mallard duck (Anas platyrhynchos)-mediated dispersal of Lemnaceae: a contributing factor in the spread of invasive Lemna minuta?

Our ability to predict and manage the spread of alien, invasive plants is limited by a lack of understanding of dispersal potential. Invasive Lemna minuta has spread within a few decennia throughout Europe. However, the mechanism by which the species continues to spread remains a matter of speculation. In this study, hypothesised epizoochorous transport of L. minuta propagules by mallard ducks was investigated. Landolt (Biosystematic investigations in the family of duckweeds (Lemnaceae) (Vol. 2), The family of Lemnaceae - a monographic study (Vol. 1), 1986, Veröffentlichungen des Geobotanischen Institutes Der Eidg. Techniasche Hochschule, Stiftung Rübel, Zürich, Switzerland) referred to desiccation as the key limitation of the "colonization capability" of Lemnaceae. Therefore, we analysed retention of viability in L. minuta kept outside the liquid growth medium. Our data show prolonged viability of L. minuta fronds inserted between the feathers of a mallard duck. Consistently, the relative humidity between feathers ranged between 65% and 90%. Taking together evidence of entanglement and retention of L. minuta between the feathers of live ducks, with retention of viability, we consider it likely that mallards contribute to L. minuta dispersal. These data have implications for the management strategy of this invasive species.

Chaos in a seasonally perturbed SIR model: avian influenza in a seabird colony as a paradigm

Seasonality is a complex force in nature that affects multiple processes in wild animal populations. In particular, seasonal variations in demographic processes may considerably affect the persistence of a pathogen in these populations. Furthermore, it has been long observed in computer simulations that under seasonal perturbations, a host-pathogen system can exhibit complex dynamics, including the transition to chaos, as the magnitude of the seasonal perturbation increases. In this paper, we develop a seasonally perturbed Susceptible-Infected-Recovered model of avian influenza in a seabird colony. Numerical simulations of the model give rise to chaotic recurrent epidemics for parameters that reflect the ecology of avian influenza in a seabird population, thereby providing a case study for chaos in a host- pathogen system. We give a computer-assisted exposition of the existence of chaos in the model using methods that are based on the concept of topological hyperbolicity. Our approach elucidates the geometry of the chaos in the phase space of the model, thereby offering a mechanism for the persistence of the infection. Finally, the methods described in this paper may be immediately extended to other infections and hosts, including humans.

Influence of disseminated neoplasia, trematode infections and gametogenesis on surfacing and mortality in the cockle Cerastoderma edule

Cerastoderma edule is a widely distributed bivalve mollusc, commercially exploited throughout Europe and is also an important food source for birds and crustaceans. Recently, mass surfacing and mortalities of cockles have been observed and reported at sites in Ireland and elsewhere, particularly in the summer months. One such site is Flaxfort Strand, Courtmacsherry Bay, County Cork, Ireland, an important feeding area used by many seabirds during the summer months. For the past few years large numbers of surfaced cockles have been observed at the site in a moribund condition. Samples of cockles from this area were collected over the summer months and their health status assessed. Cockles that had surfaced (moribund) and those still buried in the sediment were quantified and screened: sex, gonadal maturity and size class of cockles were also determined. Disseminated neoplasia and trematodes were observed in screened cockles. The most significant finding during the study was that mortalities and surfacing of cockles was related to a greater incidence of disseminated neoplasia. No neoplasia was observed in the smallest and largest size classes. There was a significantly higher prevalence of neoplasia in moribund cockles than in buried cockles, whereas in both groups a similar concentration of trematode metacercariae was observed in the screened tissues. Also, most of the cockles that had surfaced were either in the process of spawning or were spent. Overall a much larger percentage of moribund cockles exhibited both trematode infections plus neoplasia compared with buried cockles. A combination of the presence of neoplasia and trematodes, along with stress related to spawning, may immunocompromise the cockless, causing the animals to surface and become moribund.

Analysis of threshold-type behaviour in mathematical models of the intrusion of a novel macroparasite in a host colony

Macroparasites include worms, ticks, mites, bugs and fleas. These parasites are well known to induce morbidity effects including a reduction in the hosts' reproductive output and survival. An important scenario is the introduction of a new macroparasite into an established host population which may be caused by the climate change and by the transport of domestic animals. The aim of the article is to demonstrate an interesting feature of this scenario using a mathematical model with four dimensionless parameters. Six possible scenarios of introducing a new macroparasite into a host colony, ranging from the elimination of the new pathogen, through guaranteed host and parasite coexistence, to the collapse of the host colony are distinguished. The threshold surfaces in the space of parameters which separate the different scenarios are found. Some special limit cases are discussed.

Aminoguanidine reduces cisplatin ototoxicity

Cisplatin is known to cause high-frequency neurosensory hearing loss. While reactive oxygen species have been shown to play a role, reactive nitrogen species have been implicated, but not proven to be involved, in cisplatin ototoxicity. The purpose of the present study was to investigate the role of nitric oxide (*NO) in cisplatin ototoxicity by administering aminoguanidine (AG), a relatively specific inhibitor of inducible nitric oxide synthase (iNOS), in conjunction with cisplatin. Rats were injected with cisplatin, AG, or both. Auditory brainstem evoked responses (ABR) were measured before and 3 days after cisplatin administration. The cochlear tissue was then assayed for *NO and malondialdehyde. Cisplatin alone caused significant ABR threshold shifts at all stimuli tested, whereas AG alone caused no shifts. There was a significant reduction in threshold shift for clicks and 16 kHz tone bursts (but not 32 kHz) when AG was given with cisplatin. The malondialdehyde concentration (but not the *NO concentration) in the AG/cisplatin group was significantly lower than that of the cisplatin group. This suggests that AG reduces cisplatin ototoxicity by directly scavenging hydroxyl radicals. The iNOS pathway may play a role in the generation of free radicals and hearing loss resulting from cisplatin administration, but this conclusion was not supported by our data.

Internal carotid artery aneurysm repair requiring skull base resection: a case study

A 51-year-old man with a history of hypertension and smoking with an internal carotid artery (ICA) aneurysm was a referral from an outside hospital. He had a history remarkable for headaches for 6 months refractory to conventional therapy, but no stroke, transient ischemic attack, seizure activity, or neck pain. Arteriogram revealed a right ICA aneurysm at the level of the skull base with no accessible cervical ICA distal to the aneurysm. The petrous and intracranial ICA were normal. A team approach to repair was undertaken with a skull base resection and ICA exposure by head and neck surgeons and vascular reconstruction with vein graft from common carotid to petrous portion of ICA by vascular surgeons. A small right parietal infarction was noted in the postoperative period and became a focus of seizure activity. Anti-seizure medication was successful and transient upper-extremity weakness cleared. Transient dysfunction of cranial nerves VII and IX developed. The complex nature of the operation required expertise from different surgical specialties, and the postoperative complication mandated medical specialty and extensive inpatient and outpatient physical, occupational, and speech therapies ICA aneurysms of the skull base are uncommon. Historic treatment involved either ligation with a high risk of stroke or bypass to intracranial artery because direct repair was difficult. With a skilled team approach, direct repair as described is effective. This article focuses on the complexity of the surgical procedure, perioperative care, outcome of surgical intervention, and a multidisciplinary approach to the care of the patient undergoing ICA aneurysm repair requiring skull base resection.

Mixed infections with tick-borne viruses in a seabird colony in Eire

Viruses were isolated from 2 tick species collected from the nesting areas of seabirds on Great Saltee Island, Eire. Bunyaviruses of the Uukuniemi serogroup were isolated from hard ticks (Ixodes uriae and I. rothschildi), bunyaviruses of the Hughes serogroup from soft ticks (Ornithodoros maritimus), and orbiviruses of the Kemerovo serogroup from I. uriae and O. maritimus. The results indicate that the bunyaviruses, but not the orbiviruses, show "tick specificity". Neutralising activity against members of all 3 serogroups was detected in sera from chicks in the nesting areas; neutralising antibodies were probably maternal.

Catholic health care institutions and social justice

What implications for the health care apostolate lie in the programs and plans of the National Conference of Catholic Bishops and the United States Catholic Conference? This question is explored through looking at the relationship of the health care ministry to NCCB and USCC priorities--social justice, family life, parish renewal, and evangelization.

Isolation of a Soldado-like virus (Hughes group) from Ornithodorus maritimus ticks in Ireland

Three isolations of a virus of the Hughes group were obtained from seabird ectoparasites, Ornithodoros (Alectorobius) maritimus, on Great Saltee Island, Ireland. The agent is closely related to Soldado virsu, originally obtained from related ticks near Trinidad, West Indies, and represents the second recorded tickborne arbovirus in Ireland.

Increasing operability and survival with intra-aortic ballon pump assist

Intra-aortic ballon pump assist (IABPA) was used over a 12-month period in the management of 41 patients: 5 patients with complications of myocardial infarction in shock whose circulation was supported by IABPA before operation immediately after angiographic and hemodynamic study (group 1); 14 patients with postcardiotomy low-output state who could not be weaned from cardiopulmonary bypass and required IABPA circulatory support either in the operating room or in the intensive care area (group 2); 19 patients with severe myocardial ischemia and unstable circulation in whom IABPA was instituted either before angiography or before saphenous vein bypass operation (group 3); and 3 patients with severe left ventricular dysfunction and left ventricular hypertrophy due to aortic valve or coronary artery disease, or both, in whom IABPA was used before, during and after cardiopulmonary bypass and a corrective operative procedure (group 4). Survival rates for patients in these groups were 2/5,8/14,18/19 and 2/3 respectively (overall survival, 73%). IABPA may increase the postoperative survival of certain high-risk patients with poor left ventricular function due to valvular disease or coronary artery disease, or both. The survival of patients with severe myocardial ischemia and complicated myocardial infarction is improved by IABPA, early angiography and appropriate surgical correction. Left ventricular ejection fraction and the estimate of subendocardial coronary flow by the ratio of the diastolic pressure time index to the tension time index appear to be significant in identifying patients who may benefit from the use of IABPA.