Antigenic targets and pathogenicity of anti-aortic endothelial cell antibodies in takayasu arteritis

Anti-endothelial cell antibodies are considered to have an important role in the pathogenesis of Takayasu arteritis (TA). Previously, these antibodies were detected using human umbilical vein endothelial cells, which do not completely represent the antigenicity/functions of aortic endothelial cells, the specific targets in TA. To delineate the precise role of antigenic targets, we investigated such targets as well as the pathogenic mechanism of antibodies directed against aortic endothelial cells (AAECAs) in TA

Body image perception, eating attitude and influence of media among undergraduate students of medical college in Delhi: a cross sectional study

Background: Body image perception is being shaped by unrealistic ideals portrayed in the media. Body dissatisfaction is one of the most consistent and robust risk factors for eating disorders, low self-esteem, depression, and obesity. Therefore, the objective of the current study is to ascertain the body image perception, abnormal eating attitudes and the role of media among undergraduate students of a medical college in Delhi, India.Methods: Cross-sectional study on 370 undergraduate medical students of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India selected using stratified random sampling. India. Students completed a self-administered questionnaire which consist of demographic information, perceived body image, Eating Attitudes test (EAT-26) to assess eating attitudes, Socio Cultural Attitude Towards Appearance Questionnaire 3(SATAQ-3) scale for the role of media on body image perception. Data was analyzed using SPSS v21.Results: A total of 370 students (57.6% males and 42.4% females) aged 17-30 years, mean age of 20.30 years±2.02(SD). Abnormal body image perception was seen in 35.4%, 21.1% had abnormal eating attitude (EAT-26≥20), 36.5%, 40.5% agreed to be influenced by models and athletic figures in media respectively, 42.2% accepted that media was their source of information regarding standards of attractiveness, 27.6% felt pressured to be attractive according to SATAQ-3. Males more than females had disordered eating attitudes and felt media pressure to achieve an ideal body image. Significant association was observed between age and perceived body image (p=0.033), gender and EAT-26 score (p=0.039), EAT 26 and perceived body image (p=0.006), general internalization of media and perceived body image (p=0.003), internalization-general, internalization-athlete, media as source of information and EAT-26 score (<0.001, 0.001, 0.003 respectively).Conclusions: The media should take more responsibility to not represent unrealistic ideals of body image concerning both males and females. Educational and preventive efforts at institutional levels should be made to promote a healthy body image and eating behaviours

Drug utilization pattern in an intensive care unit setting in Eastern India

Background: The intensive care unit (ICU) is a setting where a large number of drugs are administered to patients, most of them critically ill and suffering from multiple complications, making the costs of hospitalization and drug treatment high. There is a dearth of information on drug utilization in ICUs in Eastern India. The present study was undertaken to evaluate the drug utilization pattern in an ICU setting in Eastern India. The objective was to monitor, evaluate, and suggest modifications in the prescribing pattern of ICU drugs.Methods: A retrospective analysis of the case records of patients admitted to the ICU of a multispecialty hospital in Eastern India during the time period from January 2015 to June 2015 was carried out. The demographic profile of the patients, drug utilization pattern and defined daily dose (DDD)/100 bed-days of the commonly used drugs in the ICU were studied.Results: A total of 275 patients were evaluated consisting 61% male patients. Most common causes for admission to the ICU were a cerebrovascular accident, chronic kidney disease, and road traffic accident. An average number of drugs per patient was 10.5. Commonly prescribed drug classes were the antimicrobial agents (AMAs) in 96% patients followed by gastrointestinal drugs. Ceftriaxone was the most commonly used AMA (41.5% patients), having a drug consumption of 35.1 DDD/100 bed-days during the study period.Conclusions: An antibiotic use policy should be framed and followed to curb the excessive use of AMAs. Formation of a multidisciplinary team to oversee drug use will be helpful to make the drug utilization in the ICU rational

Idiopathic clubfoot treated by Ponseti method: a series of 300 cases

Background: Clubfoot is a complicated deformity of the foot. It is one of the commonest congenital deformities in children. The main aim of this study was to evaluate the efficacy management of clubfoot by Ponseti method.Methods: This prospective study included 300 children (456 club feet) below the age of 2 years with idiopathic clubfeet from January 2013 to December 2017. In all the cases the Ponseti method was used for the management. The severity of the deformity was assessed with the help of the Pirani score and clinical evaluation of the foot was done.Results: Out of 300 patients 204 patients were male and 96 patients were female and 144 were unilateral clubfoot and 156 were bilateral cases of clubfoot. The mean number of casts required for correction was 5.4 (4–10). Out of 456 clubfeet 356 (78%) feet were required tenotomy. There was relapse seen in 36 (7.9%) feet which had to be managed with 2–3 serial manipulations and casting and these resolved. Excellent result found in our study in 92% cases, good results were found in 5% cases and poor results were found in 3% cases.Conclusions: Ponseti technique is a very useful and effective method of management of idiopathic clubfoot up to 2 year of age

Alloimmunity and Tolerance in Corneal Transplantation

Corneal transplantation is one of the most prevalent and successful forms of solid tissue transplantation. Despite favorable outcomes, immune-mediated graft rejection still remains the major cause of corneal allograft failure. While ‘low risk’ graft recipients with uninflamed graft beds enjoy a success rate of approximately 90%, the rejection rates in inflamed graft beds or ‘high risk’ recipients often exceed 50% despite maximal immune suppression. In this review we discuss the critical facets of corneal alloimmunity, including immune and angiogenic privilege, mechanisms of allosensitization, cellular and molecular mediators of graft rejection, and allotolerance induction

Combining ability analysis in linseed (Linum usitatissimum L.) for improvement of seed yield and its component traits

Twenty eight hybrids developed from eight genotypes of linseed through diallel mating design (excluding reciprocal) along with one checks viz., Shekhar were evaluated in randomized block design with three replications for eleven distinct morphological traits during rabi season of 2012-13, to estimate the general combining ability (GCA) of the parents and specific combining ability (SCA) of hybrids considered for the development of high yielding varieties. The analysis of variance for combining ability revealed significant mean sum of squares due to GCA and SCA for all the traits under study. Genotype EC-1392 (0.50) and TL-11 (0.45) has been found good general combiner with highest magnitude of GCA effects for seed yield per plant. In addition to above, EC-1392 and TL-11 also showed good GCA effects for plant height, secondary branches per plant, capsules per plant and biological yield per plant. Hybrids A.95.B x Shekhar (2.43), TL-11 x EC-1392 (1.71) and NDL-2004-05 x GS-234 (1.53) showed higher positive significant SCA effects for seed yield per plant. These hybrids also exhibited positive significant SCA effects for plant height, secondary brances per plant, capsules per plant, indicating potential for exploiting hybrid vigour in breeding programme

Role of CCR7 in Facilitating Direct Allosensitization and Regulatory T-Cell Function in High-Risk Corneal Transplantation

Purpose. Chemokine receptor 7 (CCR7) is a key homing molecule for immune cell trafficking, including corneal antigen-presenting cell (APC) migration from the inflamed cornea to draining lymph nodes (LNs). Here, the authors investigated the effect of CCR7-facilitated donor APC trafficking on allosensitization, regulatory T-cell (Treg) function, and graft survival in corneal transplantation. Methods. CCR7−/− or wild-type (WT) allogeneic corneal grafts were transplanted onto the neovascularized high-risk recipient beds. Two weeks later, the frequency of directly alloprimed host T cells was measured by the IFN-γ ELISPOT assay. Treg function was tested by a coculture suppression assay and an IFN-γ ELISPOT assay. Kaplan-Meier analysis was performed to evaluate graft survival. Results. The recipients of CCR7−/− grafts had fewer migrated donor APCs and lower frequency of IFN-γ–producing T cells in the draining LNs. However, there was no statistically significant difference in transplant survival between recipients of CCR7−/− and those of WT grafts. Tregs from the CCR7−/− graft recipient group showed reduced regulatory potential for the suppression of proliferation of naive T cells and direct alloprimed T cells and expressed lower Foxp3 levels. In vitro studies confirmed that mature CCR7+ major histocompatibility complex class II+ CD86+ graft-derived dendritic cells were critical for Treg function. Conclusions. Not only is CCR7-mediated donor-derived APC trafficking to the draining LNs important in the initiation of host T-cell priming, it is crucial for Treg-mediated tolerance

Regulation of Blood Vessel versus Lymphatic Vessel Growth in the Cornea

Purpose In the present study, the authors developed novel models to stimulate blood vessel formation (hemangiogenesis) versus lymphatic vessel formation (lymphangiogenesis) in the cornea. Methods Micropellets loaded with high-dose (80 ng) or low-dose (12.5 ng) basic fibroblast growth factor (bFGF) were placed in BALB/c corneas. Angiogenic responses were analyzed by immunohistochemistry to quantify blood neovessels (BVs) and lymphatic neovessels (LVs) to 3 weeks after implantation. Areas covered by BV and LV were calculated and expressed as a percentage of the total corneal area (percentage BV and percentage LV). Hemangiogenesis (HA) and lymphangiogenesis (LA) were also assessed after antibody blockade of VEGFR-2 or VEGFR-3 Results Although high-dose bFGF stimulation induced a more potent angiogenic response, the relative LV (RLV = percentage LV/percentage BV × 100) was nearly identical with high- and low-doses of bFGF. Delayed LA responses induced 3 weeks after implantation of high-dose bFGF resulted in a lymphatic vessel-dominant phenotype. Interestingly, the blockade of VEGFR-2 significantly suppressed BV and LV. However, the blockade of VEGFR-3 inhibited only LV (P = 0.0002) without concurrent inhibition of BV (P = 0.79), thereby resulting in a blood vessel-dominant phenotype Conclusions An HA-dominant corneal phenotype can be obtained in BALB/c mice 2 weeks after implantation of an 80-ng bFGF micropellet with VEGFR-3 blockade. Alternatively, an LA-dominant corneal phenotype can be obtained 3 weeks after implantation of an 80-ng bFGF micropellet without supplementary modulating agents. These models will be useful in evaluating the differential contribution of BV and LV to a variety of corneal abnormalities, including transplant rejection, wound healing and microbial keratitis

The Role of ACAID and CD4+CD25+FOXP3+ Regulatory T Cells on CTL Function Against MHC Alloantigens

Purpose: Anterior chamber associated immune deviation (ACAID) is an antigen-specific form of peripheral immune tolerance that is induced to exogenous antigens placed in the ocular anterior chamber, which leads to a suppression in delayed-type hypersensitivity (DTH). Considerable work has been done on ACAID induction to major histocompatibility (MHC) alloantigens. However, its role on cytotoxic T lymphocyte (CTL) activity is currently unknown. Methods: C57BL/6 (H-2b) mice received an intracameral (IC) inoculation with BALB/c (H-2d) splenocytes. Splenic CD4+ and CD8+ T cell populations were characterized by flow cytometry and proliferation assays during induction and expression phases of ACAID. Percentages of CD4+CD25+FoxP3+ T regulatory cells (Treg) were also followed. Lastly, CTL function was measured at various time points during ACAID expression, and Treg were added to identify potential alterations in CTL function. Results: CD4+ and CD8+ T cell percentages and proliferation increased in the spleen during ACAID induction but then sharply decreased in response to an allospecific immunization. Expression of ACAID also exhibited a significant drop in CTL function. However, while Treg expansion was observed, these cells did not directly mediate the CTL inhibition. Conclusions: ACAID mediates an inhibition of CTL function against MHC alloantigens. Furthermore, we found that ACAID induction leads to the expansion and proliferation of CD4+ and CD8+ T cells while ACAID expression is associated with a diminishment in T cell percentages due to proliferation impairment. Lastly, Treg also expand during ACAID induction. However, our data suggest that Treg do not directly inhibit CTL activity