Innováció és oktatás az élhetőbb vidékért

Background: The influence of the intra-uterine environment on the immunity and allergy development in the offspring is unclear. We aimed to investigate (i) whether the pregnancy magnifies the Th2 immunity in allergic and non-allergic women, (ii) whether the maternal chemokine levels during pregnancy influenced the offspring’s chemokine levels during childhood and (iii) the relationship between circulating Th1/Th2-associated chemokines and allergy in mothers and children. Methods: The Th1-associated chemokines CXCL9, CXCL10, CXCL11, and the Th2- associated chemokines CCL17, CCL18 and CCL22 were quantified by Luminex and ELISA in 20 women with and 36 women without allergic symptoms at gestational week (gw) 10–12, 15–16, 25, 35, 39 and 2 and 12 months post-partum and in their children at birth, 6, 12, 24 months and 6 yr of age. Total IgE levels were measured using ImmunoCAP Technology. Results: The levels of the Th2-like chemokines were not magnified by pregnancy. Instead decreased levels were shown during pregnancy (irrespectively of maternal allergy status) as compared to post-partum. In the whole group, the Th1-like chemokine levels were higher at gw 39 than during the first and second trimester and post-partum. Maternal CXCL11, CCL18 and CCL22 levels during and after pregnancy correlated with the corresponding chemokines in the offspring during childhood. Increased CCL22 and decreased CXCL10 levels in the children were associated with sensitisation and increased CCL17 levels with allergic symptoms during childhood. Maternal chemokine levels were not associated with maternal allergic disease. Conclusions: Allergic symptoms and sensitisation were associated with decreased Th1-and increased Th2-associated chemokine levels during childhood, indicating a Th2 shift in the allergic children, possibly influenced by the maternal immunity during pregnancy

Implied Contribution Under the Federal Securities Laws: A Reassessment

Exposure to a strong T-helper 2 (Th2)-like environment during fetal development may promote allergy development. Increased cord blood (CB) levels of the Th2-associated chemokine CCL22 were associated with allergy development during the first 2 y of life. The aim of the present study was to determine whether CB Th1- and Th2-associated chemokine levels are associated with allergy development during the first 6 y of life, allowing assessment of respiratory allergic symptoms usually developing in this period. The CB levels of cytokines, chemokines, and total IgE were determined in 56 children of 20 women with allergic symptoms and 36 women without allergic symptoms. Total IgE and allergen-specific IgE antibody levels were quantified at 6, 12, 24 mo, and 6 y of age. Increased CB CCL22 levels were associated with development of allergic sensitization and asthma and increased CCL17 levels with development of allergic symptoms, including asthma. Sensitized children with allergic symptoms showed higher CB CCL17 and CCL22 levels and higher ratios between these Th2-associated chemokines and the Th1-associated chemokine CXCL10 than nonsensitized children without allergic symptoms. A pronounced Th2 deviation at birth, reflected by increased CB CCL17 and CCL22 levels, and increased CCL22/CXCL10 and CCL17/CXCL10 ratios might promote allergy development later in life

Två skolvärldars möte. En institutionsskolas fysiska integrering med en kommunal grundskola i ett inkluderande perspektiv

Syfte: Studien syftar till att undersöka rektorers och lärares uppfattningar om hur en institutionsskola för elever med rörelsehinder och en kommunal skolas värld gestaltar sig i nuläget med tanke på delaktighet, samarbete och gemenskap i en för dem gemensam skola samt vilka framtidsvisioner som finns. Problemformulering: • Hur möts de båda världarna i nuläget i det praktiska vardagsarbetet? • Vilka framtidsvisioner finns? Teorianknytning Examensarbetet knyter an till det kategoriska och till relationella perspektivet som framställts av Persson (2003). I det kategoriska perspektivet utgår man från de konsekvenser, som följer efter det att det skett en diagnosticering grundad på en medicinpsykologisk modell som lägger fokus på avvikel-serna hos elever. I det relationella perspektivet förutsätts att de förändringar och anpassningar som görs i miljön genomförs efter faktumet att individerna är olika, beror snarare på en systemförändring än en individförändring. Metod: En kvalitativ fallstudie valdes och metoden för arbetet var semistrukturerade intervjuer med fyra rektorer och sex lärare. Resultat: I undersökningen framkom att rektorernas syn på nuläget för de båda skolformerna inte är samstämmiga när de gäller verksamhetsfrågor. Obalansen på ledningsnivå hänger bl.a. ihop med att det skett många byten av rektorer, samtidigt som ledningen på förvaltningsnivå inte är färdigställd. Skolans resursteam fungerar inte, då dess handläggningstider är för långa. När begreppet integrering/ inkludering berörs, nämns två elever från den tidigare institutionsskolan som skolans exempel. Skolan önskar att stadsdelsförvaltningen blir mer aktiv i utvecklingsarbetet. I rektorsgruppen finns det enskilda uppfattningar om hur skolformerna skall hanteras. En rektor strävar mot en tydlig särskiljning medan en annan vill skapa en helhet. I rektorernas visioner finns en önskan att på alla nivåer arbeta för att skapa en samhörighet. Lärarnas syn på nuläget är att de är besvikna över att organisationen är ostrukturerad och ledarskapet begränsat och otydligt. Lärarna menar att de inte får den hjälp de behöver i sitt dagliga arbete. De upplever att de själva får ta sig an arbetsuppgifter som borde utföras av ansvariga rektorer. Lärarna på Frölundaskolan har ett ömsesidigt samarbete för att klara vardagen. Lärarna på de båda skolorna har en vision om en helintegrerad verksamhet med en rektor. Det finns ingen d v s att det inte finns någon särskiljning av de olika skolformerna. Rektorerna borde vara ute i den dagliga verksamheten samt samarbeta på alla nivåer. Bräcke Östergårdsskolan har en önskan om att deras arbete blir synliggjort både i och utanför skolans väggar. Undersökningen visade att i nuläget finns ett relationellt perspektiv och en överrepresentation av det kategoriska perspektivet i båda verksamheterna, men en strävan mot en mer inkluderande verksamhet framkom i visionen

Immunological interactions between mother and child during pregnancy in relation to the development of allergic diseases in the offspring

Background: Pregnancy and allergic disease have both been postulated as T-helper 2 (Th2) phenomena. Thus, the increased propensity of allergic mothers to mount Th2-responses might generate favourable effects on the maintenance of pregnancy, but might also be unfavorable, as fetal exposure to a strong Th2 environment could influence the immune development in the offspring to a Th2-like phenotype, favouring IgE production and possibly allergy development later in life. The influence of the intrauterine environment on the immunity and allergy development in the offspring needs to be further investigated. Aim: The aim of this thesis was to explore the Th1/Th2 balance in allergic and non-allergic women during pregnancy and its influence on the shaping of the Th1/Th2 profile in the neonate and the development of allergic diseases in the offspring. Material and methods: The study group included 20 women with and 36 women without allergic symptoms followed during pregnancy (gestational week 10-12, 15-16, 25, 35, 39) and 2 and 12 months postpartum, and their children followed from birth to 6 years of age. The circulating Th1-like chemokines CXCL9, CXCL10, CXCL11, Th2-like chemokines CCL17, CCL18 and CCL22, and the allergen-induced secretion of interleukin-4 (IL-4), IL-5, IL-10, IL-13, Interferon-γ (IFN-γ), CXCL10 and CCL17 were measured by Luminex and ELISA. The allergen-specific and total IgE levels were quantified using ImmunoCAP Technology. mRNA expression of Th1-, Th2-, Treg- and Th17-associated genes were measured by PCR arrays and real-time PCR. Results: We found that sensitised women with allergic symptoms had increased total IgE levels and birch- and cat-induced IL-5, IL-13 and CCL17 responses during pregnancy as compared with postpartum. The non-sensitised women without allergic symptoms had elevated cat-induced IL-5 and IL-13 responses and lower birch- and cat-induced IFN-γ during pregnancy, but similar IgE levels as compared with postpartum. Maternal total IgE levels during and after pregnancy correlated with cord blood (CB) IgE and CCL22 levels (regardless of maternal allergy status). Circulating CXCL11, CCL18 and CCL22 levels during pregnancy and postpartum correlated with the corresponding chemokine levels in the offspring at various time points during childhood. Maternal IL-5 expression in peripheral blood mononuclear cells (PBMC) was associated with neonatal Galectin-1, and placental p35 expression was negatively associated with neonatal Tbx21 expression. Increased mRNA expression of CCL22 in cord blood mononuclear cells (CBMC), and increased CCL17 and CCL22 levels in CB were observed in children later developing allergic symptoms and sensitisation as compared with children who did not. Development of allergic symptoms and sensitisation were associated with increased total IgE, CCL17, CCL18 and CCL22 levels during childhood. Conclusions: Maternal allergy was associated with a pronounced Th2 deviation during pregnancy, shown as increased total IgE levels and birch- and cat-induced IL-5, IL-13 and CCL17 responses during pregnancy, possibly exposing their fetuses to a particular strong Th2 environment during gestation. Correlations were shown between the maternal immunity during pregnancy and the offspring’s immunity at birth and later during childhood, indicating an interplay between the maternal and fetal immunity. Allergy development during the first 6 years of life was associated with a marked Th2 deviation at birth and a delayed down-regulation of this Th2-skewed immunity during childhood