Induction of Glucose Metabolism in Stimulated T Lymphocytes Is Regulated by Mitogen-Activated Protein Kinase Signaling

T lymphocytes play a critical role in cell-mediated immune responses. During activation, extracellular and intracellular signals alter T cell metabolism in order to meet the energetic and biosynthetic needs of a proliferating, active cell, but control of these phenomena is not well defined. Previous studies have demonstrated that signaling from the costimulatory receptor CD28 enhances glucose utilization via the phosphatidylinositol-3-kinase (PI3K) pathway. However, since CD28 ligation alone does not induce glucose metabolism in resting T cells, contributions from T cell receptor-initiated signaling pathways must also be important. We therefore investigated the role of mitogen-activated protein kinase (MAPK) signaling in the regulation of mouse T cell glucose metabolism. T cell stimulation strongly induces glucose uptake and glycolysis, both of which are severely impaired by inhibition of extracellular signal-regulated kinase (ERK), whereas p38 inhibition had a much smaller effect. Activation also induced hexokinase activity and expression in T cells, and both were similarly dependent on ERK signaling. Thus, the ERK signaling pathway cooperates with PI3K to induce glucose utilization in activated T cells, with hexokinase serving as a potential point for coordinated regulation

Reconstruction versus conservative treatment after rupture of the anterior cruciate ligament: cost effectiveness analysis

BACKGROUND: The decision whether to treat conservatively or reconstruct surgically a torn anterior cruciate ligament (ACL) is an ongoing subject of debate. The high prevalence and associated public health burden of torn ACL has led to continuous efforts to determine the best therapeutic approach. A critical evaluation of benefits and expenditures of both treatment options as in a cost effectiveness analysis seems well-suited to provide valuable information for treating physicians and healthcare policymakers. METHODS: A literature review identified four of 7410 searched articles providing sufficient outcome probabilities for the two treatment options for modeling. A transformation key based on the expert opinions of 25 orthopedic surgeons was used to derive utilities from available evidence. The cost data for both treatment strategies were based on average figures compiled by Orthopaedic University Hospital Balgrist and reinforced by Swiss national statistics. A decision tree was constructed to derive the cost-effectiveness of each strategy, which was then tested for robustness using Monte Carlo simulation. RESULTS: Decision tree analysis revealed a cost effectiveness of 16,038 USD/0.78 QALY for ACL reconstruction and 15,466 USD/0.66 QALY for conservative treatment, implying an incremental cost effectiveness of 4,890 USD/QALY for ACL reconstruction. Sensitivity analysis of utilities did not change the trend. CONCLUSION: ACL reconstruction for reestablishment of knee stability seems cost effective in the Swiss setting based on currently available evidence. This, however, should be reinforced with randomized controlled trials comparing the two treatment strategies

Effects of second-generation and indoor sports surfaces on knee joint kinetics and kinematics during 45° and 180° cutting manoeuvres, and exploration using statistical parametric mapping and Bayesian analyses

Purpose: The aim of the current investigation was to examine the influence of second generation (2G) and indoor surfaces on knee joint kinetics, kinematics, frictional and muscle force parameters during 45° and 180° change of direction movements using statistical parametric mapping (SPM) and Bayesian analyses. Methods: Twenty male participants performed 45° and 180° change of direction movements on 2G and indoor surfaces. Lower limb kinematics were collected using an eight-camera motion capture system and ground reaction forces were quantified using an embedded force platform. ACL, patellar tendon and patellofemoral loading was examined via a musculoskeletal modelling approaches and the frictional properties of the surfaces were examined using ground reaction force information. Differences between surfaces were examined using SPM and Bayesian analyses. Results: Both SPM and Bayesian analyses showed that ACL loading parameters were greater in the 2G condition in relation to the indoor surface. Conversely, SPM and Bayesian analyses confirmed that patellofemoral/ patellar tendon loading alongside the coefficient of friction and peak rotational moment were larger in the indoor condition compared to the 2G surface. Conclusions: This study indicates that the indoor surface may improve change of direction performance owing to enhanced friction at the shoe-surface interface but augment the risk from patellar tendon/ patellofemoral injuries; whereas the 2G condition may enhance the risk from ACL pathologies