Importance of heterogeneity in Porhyromonas gingivalis lipopolysaccharide lipid A in tissue specific inflammatory signaling

Lipopolysaccharide (LPS) of Porphyromonas gingivalis exists in at least two known forms, O-LPS and A-LPS. A-LPS shows heterogeneity in which two isoforms designated LPS1435/1449 and LPS1690 appear responsible for tissue specific immune signalingpathways activation and increased virulence. The modification of lipid A to tetra-acylated1435/1449 and/or penta-acylated1690 fatty acids indicates poor growth conditions and bioavailability of hemin. Hemin protects P. gingivalis from serum resistance and the lipid A serves as a site for its binding. The LPS1435/1449 and LPS1690 isoforms can produce opposite effects on the human Toll-like receptors (TLR) TLR 2 and TLR 4 activation. This enabless P. gingivalis to select the conditions for its entry, survival and that of its co-habiting species in the host, orchestrating its virulence to control innate immune pathway activation and biofilm dysbiosis. Thismini review describes a number of effects that LPS1435/1449 and LPS1690 can exert on the host tissues such as deregulation of the innate immune system, subversion of host cell autophagy, regulation of outer membrane vesicle production and adverse effects on pregnancy outcome. The ability to change its LPS1435/1449 and/or LPS1690 composition may enables P. gingivalis to paralyze local pro-inflammatory cytokine production, thereby gaining access to its primary location in periodontal tissue

Brief Screening Measures Identify Risk for Psychological Difficulties Among Children with Sickle Cell Disease

Children with sickle cell disease (SCD) experience disproportionately high rates of psychological problems. Our goal was to examine the clinical utility of psychological screening measures to identify children with such problems in medical settings. Caregivers completed screening measures assessing social-emotional problems, ADHD symptoms, executive dysfunction, and health-related quality of life (HRQOL) for children with SCD (receiving either chronic blood transfusion or hydroxyurea) and their siblings. Our findings demonstrated that screening measures identified clinically elevated symptoms in children with SCD that had not been previously reported. Scores for siblings were for the most part in the normal range. The number of days hospitalized (but not cerebral infarct status) predicted higher scores, emphasizing the challenges associated with SCD complications. Overall, our findings support the notion that screening measures reduce the need for reliance on medical provider judgment for psychological referrals and increase equitability in access to services. Early identification resulting in early intervention has contributed substantially to improved psychological functioning in many contexts, and it is thus likely that such improvements would also be achieved in this uniquely vulnerable population