Peyer's Patches: The Immune Sensors of the Intestine

The gut-associated lymphoid tissue (GALT) consists of isolated or aggregated lymphoid follicles forming Peyer's patches (PPs). By their ability to transport luminal antigens and bacteria, PPs can be considered as the immune sensors of the intestine. PPs functions like induction of immune tolerance or defense against pathogens result from the complex interplay between immune cells located in the lymphoid follicles and the follicle-associated epithelium. This crosstalk seems to be regulated by pathogen recognition receptors, especially Nod2. Although TLR exerts a limited role in PP homeotasis, Nod2 regulates the number, size, and T-cell composition of PPs, in response to the gut flora. In turn, CD4+ T-cells present in the PP are able to modulate the paracellular and transcellular permeabilities. Two human disorders, Crohn's disease and graft-versus-host disease are thought to be driven by an abnormal response toward the commensal flora. They have been associated with NOD2 mutations and PP dysfunction

Quality of Life of Infants with Functional Gastrointestinal Disorders: A Large Prospective Observational Study

Background: Functional gastrointestinal disorders (FGID) are very common during infancy, leading to frequent medical consultations. The aim of this large, prospective study was to assess the quality of life (QoL) and clinical management of infants with FGID.Methods: Completely or partially bottle-fed infants under 5 months old, presenting one or more FGID (regurgitation, constipation, diarrhea, crying/fussing), were enrolled during initial consultation by 111 pediatricians in private practice throughout France and reassessed at one month. Parents were asked to complete the QUALIN QoL questionnaire at inclusion and at Day 15.Results: A total of 815 infants (mean age 2.1±1.2 months) were evaluable. Mean QoL score improved from +27.2±15.1 at inclusion to +38.0±12.9 at day 15 (p<0.0001) irrespective of FGID symptoms. Multivariate analysis indicated that younger age, dietary advice, and partial breastfeeding were associated with better QoL outcome. Gastrointestinal symptoms showed significant regression at Day 30. The number of bottle feeds followed by external reflux episodes decreased from 80.0±27.4% to 36.1±31.4% at Day 30 (p<0.0001), the weekly number of stools increasing from 3.9±4.0 to 8.0±3.7 (p<0.0001).Conclusion: Medical management based on information, reassurance, lifestyle advice and dietary intervention improved QoL in infants with FGID and led to a reduction in FGID symptoms

Asian monsoon hydrometeorology from TES and SCIAMACHY water vapor isotope measurements and LMDZ simulations: Implications for speleothem climate record interpretation

International audienceObservations show that heavy oxygen isotope composition in precipitation (delta O-18(p)) increases from coastal southeastern (SE) China to interior northwestern (NW) China during the wet season, contradicting expectations from simple Rayleigh distillation theory. Here we employ stable isotopes of precipitation and vapor from satellite measurements and climate model simulations to characterize the moisture processes that control Asian monsoon precipitation and relate these processes to speleothem paleoclimate records. We find that delta O-18(p) is low over SE China as a result of local and upstream condensation and that delta O-18(p) is high over NW China because of evaporative enrichment of O-18 as raindrops fall through dry air. We show that delta O-18(p) at cave sites over southern China is weakly correlated with upstream precipitation in the core of the Indian monsoon region rather than local precipitation, but it is well-correlated with the delta O-18(p) over large areas of southern and central China, consistent with coherent speleothem delta O-18(p) variations over different parts of China. Previous studies have documented high correlations between speleothem delta O-18(p) and millennial timescale climate forcings, and we suggest that the high correlation between insolation and speleothem delta O-18(p) in southern China reflects the variations of hydrologic processes over the Indian monsoon region on millennial and orbital timescales. The delta O-18(p) in the drier part (north of similar to 30 degrees N) of China, on the other hand, has consistently negative correlations with local precipitation and may capture local hydrologic processes related to changes in the extent of the Hadley circulation

Parafoveal OCT Angiography Features in Diabetic Patients without Clinical Diabetic Retinopathy: A Qualitative and Quantitative Analysis

Purpose. To evaluate the capacity of OCT angiography (OCTA) for detecting infraclinical lesions in parafoveal capillaries in diabetic patients without diabetic retinopathy (DR). Methods. This prospective observational cross-sectional case-control study analyzed the superficial and deep capillary plexuses (SCP and DCP) on macular OCTA scans (3 × 3 mm) centered on the fovea. We compared 22 diabetic patients (34 eyes included) without DR diagnosis on color fundus photographs, with 22 age- and gender-matched nondiabetic controls (40 eyes included). Qualitative analysis concerned morphological ischemic capillary alterations. Quantitative analysis measured foveal avascular zone (FAZ) size, parafoveal capillary density, and enlargement coefficient of FAZ between SCP and DCP. Results. Neither the qualitative nor quantitative parameters were significantly different between both groups. No microaneurysms or venous tortuosity was observed in any of the analyzed images. On the SCP, the mean FAZ area was 0.322 ± 0.125 mm2 in diabetic patients and 0.285 ± 0.150 mm2 in controls, P=0.31. On the DCP, the mean FAZ area was 0.444 ± 0.153 mm2 in cases and 0.398 ± 0.138 mm2 in controls, P=0.20. Conclusion. OCTA did not detect infraclinical qualitative or quantitative differences in parafoveal capillaries of diabetic patients without DR in comparison with nondiabetic controls

Understanding psychotic-like experiences in children in the context of dimensions of psychological problems

Introduction: Although psychotic behaviors can be difficult to assess in children, early identification of children at high risk for the emergence of psychotic symptoms may facilitate the prevention of related disorders. Psychotic-like experiences (PLEs), or subthreshold thought and perceptual disturbances, could be early manifestations of psychosis that may predict a future diagnosis of a psychosis-related disorder or nonspecific correlates of a wide range of psychological problems. Additional research is needed regarding how PLEs map onto dimensions of psychopathology in children. Methods: In the present study, we examined the association between PLEs and general and specific dimensions of psychological problems in a sample of 10,692 children from the Adolescent Brain Cognitive Development Study (ABCD Study). Results: The results of this study showed that self-reported PLEs were associated with a general psychopathology factor and an ADHD factor, which were defined in hierarchical models of parent-rated psychological problems. Discussion: These findings suggest that PLEs are broadly associated with a wide range of psychological problems through the general psychopathology factor even before psychotic disorders typically manifest. This study supports the need for longitudinal analyses of future waves of the ABCD Study to determine if PLEs can detect children at high risk for serious psychological problems in adulthood.</p

Optical Coherence Tomography Angiography to Distinguish Changes of Choroidal Neovascularization after Anti-VEGF Therapy: Monthly Loading Dose versus Pro Re Nata Regimen

Purpose. To compare the qualitative and quantitative choroidal neovascularization (CNV) changes after antivascular endothelial growth factor (anti-VEGF) therapy in treatment-naïve and treated eyes with age-related macular degeneration (AMD) using optical coherence tomography angiography (OCTA). Methods. Consecutive patients with neovascular AMD underwent multimodal imaging, including OCTA (AngioPlex, CIRRUS HD-OCT model 5000; Carl Zeiss Meditec, Inc., Dublin, OH) at baseline and at three monthly follow-up visits. Treatment-naive AMD patients undergoing anti-VEGF loading phase were included in group A, while treated patients were included in group B. Qualitative and quantitative OCTA analyses were performed on outer retina to choriocapillaris (ORCC) slab. CNV size was measured using a free image analysis software (ImageJ, open-source imaging processing software, 2.0.0). Results. Twenty-five eyes of 25 patients were enrolled in our study (mean age 78.32 ± 6.8 years): 13 treatment-naïve eyes in group A and 12 treated eyes in group B. While qualitative analysis revealed no significant differences from baseline to follow-up in the two groups, quantitative analysis showed in group A a significant decrease in lesion area (P=0.023); in group B, no significant change in the lesion area was observed during anti-VEGF therapy (P=0.93). Conclusion. Treatment-naïve and treated eyes with CNV secondary to neovascular AMD respond differently to anti-VEGF therapy. This should be taken into account when using OCTA for CNV follow-up or planning therapeutic strategies

An assessment of the Arctic Ocean in a suite of interannual CORE-II simulations. Part III: Hydrography and fluxes

In this paper we compare the simulated Arctic Ocean in 15 global ocean–sea ice models in the framework of the Coordinated Ocean-ice Reference Experiments, phase II (CORE-II). Most of these models are the ocean and sea-ice components of the coupled climate models used in the Coupled Model Intercomparison Project Phase 5 (CMIP5) experiments. We mainly focus on the hydrography of the Arctic interior, the state of Atlantic Water layer and heat and volume transports at the gateways of the Davis Strait, the Bering Strait, the Fram Strait and the Barents Sea Opening. We found that there is a large spread in temperature in the Arctic Ocean between the models, and generally large differences compared to the observed temperature at intermediate depths. Warm bias models have a strong temperature anomaly of inflow of the Atlantic Water entering the Arctic Ocean through the Fram Strait. Another process that is not represented accurately in the CORE-II models is the formation of cold and dense water, originating on the eastern shelves. In the cold bias models, excessive cold water forms in the Barents Sea and spreads into the Arctic Ocean through the St. Anna Through. There is a large spread in the simulated mean heat and volume transports through the Fram Strait and the Barents Sea Opening. The models agree more on the decadal variability, to a large degree dictated by the common atmospheric forcing. We conclude that the CORE-II model study helps us to understand the crucial biases in the Arctic Ocean. The current coarse resolution state-of-the-art ocean models need to be improved in accurate representation of the Atlantic Water inflow into the Arctic and density currents coming from the shelves

Prevalence of HPV Infection in Racial-Ethnic Subgroups of Head and Neck Cancer Patients

The landscape of HPV infection in racial/ethnic subgroups of head and neck cancer (HNC) patients has not been evaluated carefully. In this study, a meta-analysis examined the prevalence of HPV in HNC patients of African ancestry. Additionally, a pooled analysis of subject-level data was also performed to investigate HPV prevalence and patterns of p16 (CDNK2A) expression amongst different racial groups. Eighteen publications (N = 798 Black HNC patients) were examined in the meta-analysis, and the pooled analysis included 29 datasets comprised of 3,129 HNC patients of diverse racial/ethnic background. The meta-analysis revealed that the prevalence of HPV16 was higher among Blacks with oropharyngeal cancer than Blacks with non-oropharyngeal cancer. However, there was great heterogeneity observed among studies (Q test P&lt;0.0001). In the pooled analysis, after adjusting for each study, year of diagnosis, age, gender and smoking status, the prevalence of HPV16/18 in oropharyngeal cancer patients was highest in Whites (61.1%), followed by 58.0% in Blacks and 25.2% in Asians (P&lt;0.0001). There was no statistically significant difference in HPV16/18 prevalence in non-oropharyngeal cancer by race (P=0.682). With regard to the pattern of HPV16/18 status and p16 expression, White patients had the highest proportion of HPV16/18+/p16+ oropharyngeal cancer (52.3%), while Asians and Blacks had significantly lower proportions (23.0% and 22.6%, respectively) [P &lt;0.0001]. Our findings suggest that the pattern of HPV16/18 status and p16 expression in oropharyngeal cancer appears to differ by race and this may contribute to survival disparities