The impact of lymph vascular space invasion on recurrence and survival in patients with early stage endometrial cancer

The aim of this study was to determine impact of lymph vascular space involvement (LVSI) on recurrence and survival in early stage of endometrial cancer. From 1991 through 2010, all endometrial cancer patients at University Hospital of Bari, Italy were identified. The Log-rank test and Kaplan-Meyer methods were used for time-to-event analysis to evaluate the effects of on lymph vascular space involvement recurrence rate and survival time. Of the 560 endometrial cancer patients, 525 underwent primary surgery. Of those, 399 had early stage disease. Three hundred and forty women were not found to have LVSI, whereas 59 were found to have lymph vascular space involvement. Forty-nine (12%) patients developed a recurrence and 20 of them showed lymph vascular space involvement. The statistical analysis demonstrated that LVSI was strongly associated with a poor survival (P < 0.0001). Lymph vascular space involvement is associated with a high risk of recurrence and poor overall survival in early stage of endometrial cancer; therefore, the clinical decision to decide whether or not a patient with early stage endometrial cancer should receive adjuvant therapy should be included the evaluation of lymph vascular space involvement.

Autoreactive T cells target peripheral nerves in Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is a rare heterogenous disorder of the peripheral nervous system, which is usually triggered by a preceding infection, and causes a potentially life-threatening progressive muscle weakness1. Although GBS is considered an autoimmune disease, the mechanisms that underlie its distinct clinical subtypes remain largely unknown. Here, by combining in vitro T cell screening, single-cell RNA sequencing and T cell receptor (TCR) sequencing, we identify autoreactive memory CD4+ cells, that show a cytotoxic T helper 1 (TH1)-like phenotype, and rare CD8+ T cells that target myelin antigens of the peripheral nerves in patients with the demyelinating disease variant. We characterized more than 1,000 autoreactive single T cell clones, which revealed a polyclonal TCR repertoire, short CDR3β lengths, preferential HLA-DR restrictions and recognition of immunodominant epitopes. We found that autoreactive TCRβ clonotypes were expanded in the blood of the same patient at distinct disease stages and, notably, that they were shared in the blood and the cerebrospinal fluid across different patients with GBS, but not in control individuals. Finally, we identified myelin-reactive T cells in the nerve biopsy from one patient, which indicates that these cells contribute directly to disease pathophysiology. Collectively, our data provide clear evidence of autoreactive T cell immunity in a subset of patients with GBS, and open new perspectives in the field of inflammatory peripheral neuropathies, with potential impact for biomedical applications.

Water quality and diarrhoeagenic Escherichia coli detection in surface Pampean aquatic systems

Many surface water systems are impacted by point source pollution from sewage discharges and industrial wastes, as well as diffuse pollution from agriculture and livestock farming, inducing a potential biohazard to human, animal, and environmental health. This study aimed to determine the presence of diarrhoeagenic Escherichia coli (DEC) pathotypes and their antibiotic resistance, as well as the bacteriological, physical, and chemical water quality conditions in two Pampean peri-urban rivers (Rojas and Salado rivers, Buenos Aires, Argentina) used for recreation. Additionally, we explored the impact of the surrounding land use on the water quality. In the Rojas (R) and Salado (S) rivers, wastewater discharges from treatment plants increased nutrient content and coliform abundances at specific sampling sites (R2 and S3) and downstream (R3 and S4, respectively). Coliform abundances correlated with ammoniacal nitrogen concentrations, both exceeding recreational use guidelines. Out of 36 samples positive for DEC virulence factors, 11 DEC strains were isolated (5 enteroaggregative, 3 enteropathogenic, 1 shigatoxigenic-stx1/stx2, 1 shigatoxigenic-stx2, 1 hybrid enteroaggregative-enterotoxigenic). Six strains were resistant to one or more antibiotics. Our results suggest that differences in E. coli pathotypes between the two rivers and the water quality of each sampling site are linked to the surrounding land use, evidencing both diffuse and point source pollution.