Recognizing and Responding to the Health Disparities of People with Disabilities

Health status is critically important to experiencing quality of life, self-sufficiency, and full participation in society. For the 54 million Americans with disabilities, maintaining health and wellness is especially important to reduce the impact of impairment on functioning in these critical life areas. Yet, people with disabilities may be the largest underserved subpopulation demonstrating health status disparities that stem from preventable secondary conditions. Healthy People 2010, the nation’s blueprint for improved health, addresses this problem in its objectives. In 2002 and 2005, the U.S. Surgeon General asked for public health efforts to improve the health and wellness of persons with disabilities. This article examines the concepts of health and wellness, summarizes currently available information documenting disparities in health for people with disabilities, and provides a framework for policy recommendations to reduce health disparities among people with disabilities

Staphylococcal SSL5 inhibits leukocyte activation by chemokines and anaphylatoxins

Staphylococcus aureus secretes several virulence factors modulating immune responses. Staphylococcal superantigen-like (SSL) proteins are a family of 14 exotoxins with homology to superantigens, but with generally unknown function. Recently, we showed that SSL5 binds to P-selectin glycoprotein ligand 1 dependently of sialyl Lewis X and inhibits P-selectin-dependent neutrophil rolling. Here, we show that SSL5 potently and specifically inhibits leukocyte activation by anaphylatoxins and all classes of chemokines. SSL5 inhibited calcium mobilization, actin polymerization, and chemotaxis induced by chemokines and anaphylatoxins but not by other chemoattractants. Antibody competition experiments showed that SSL5 targets several chemokine and anaphylatoxin receptors. In addition, transfection studies showed that SSL5 binds glycosylated N-termini of all G protein-coupled receptors (GPCRs) but only inhibits stimuli of protein nature that require the receptor N-terminus for activation. Furthermore, SSL5 increased binding of chemokines to cells independent of chemokine receptors through their common glycosaminoglycan-binding site. Importance of glycans was shown for both GPCR and chemokine binding. Thus, SSL5 is an important immunomodulatory protein of S aureus that targets several crucial, initial stages of leukocyte extravasation. It is therefore a potential new antiinflammatory compound for diseases associated with chemoattractants and their receptors and disorders characterized by excessive recruitment of leukocytes. (Blood. 2009;113:328-337