GM-CSF Increases Mucosal and Systemic Immunogenicity of an H1N1 Influenza DNA Vaccine Administered into the Epidermis of Non-Human Primates

Background: The recent H5N1 avian and H1N1 swine-origin influenza virus outbreaks reaffirm that the threat of a worldwide influenza pandemic is both real and ever-present. Vaccination is still considered the best strategy for protection against influenza virus infection but a significant challenge is to identify new vaccine approaches that offer accelerated production, broader protection against drifted and shifted strains, and the capacity to elicit anti-viral immune responses in the respiratory tract at the site of viral entry. As a safe alternative to live attenuated vaccines, the mucosal and systemic immunogenicity of an H1N1 influenza (A/New Caledonia/20/99) HA DNA vaccine administered by particle-mediated epidermal delivery (PMED or gene gun) was analyzed in rhesus macaques. Methodology/Principal Findings: Macaques were immunized at weeks 0, 8, and 16 using a disposable single-shot particlemediated delivery device designed for clinical use that delivers plasmid DNA directly into cells of the epidermis. Significant levels of hemagglutination inhibiting (HI) antibodies and cytokine-secreting HA-specific T cells were observed in the periphery of macaques following 1-3 doses of the PMED HA DNA vaccine. In addition, HA DNA vaccination induced detectable levels of HA-specific mucosal antibodies and T cells in the lung and gut-associated lymphoid tissues of vaccinated macaques. Importantly, co-delivery of a DNA encoding the rhesus macaque GM-CSF gene was found to significantly enhance both the systemic and mucosal immunogenicity of the HA DNA vaccine. Conclusions/Significance: These results provide strong support for the development of a particle-mediated epidermal DNA vaccine for protection against respiratory pathogens such as influenza and demonstrate, for the first time, the ability of skindelivered GM-CSF to serve as an effective mucosal adjuvant for vaccine induction of immune responses in the gut and respiratory tract. © 2010 Loudon et al

Intérêt de l'imagerie par résonance magnétique dans les spondylarthropathies séronégatives

Les spondylarthropathies séronégatives représentent un important groupe de maladies rhumatismales auquel appartiennent les spondylarthropathies ankylosantes, l'arthrite psoriasique et les arthrites réactionnelles. En principe, elles peuvent atteindre toutes les articulations, mais prédominent au niveau du squelette axial. SI aucun critère clinique fiable n'est présent, le diagnostic est généralement posé trop tardivement. L'IRM permet de suivre l'évolution clinique de la maladie Inflammatoire de son stade d'enthésopathie inflammatoire au stade chronique, y compris ses complications éventuelles

Extensor carpi ulnaris injuries in tennis players: a study of 28 cases

Pain on the ulnar side of the wrist is common among elite tennis players. Ten years of experience has allowed identification of a pathology involving the extensor carpi ulnaris (ECU) tendon. On the basis of 28 clinical cases seen over the last five years, three clinical patterns are described: (a) acute instability of the ECU; (b) tendinopathy; (c) ECU rupture. Each of these clinical entities requires a different therapeutic approach. A review of the relevant anatomy is provided

MR imaging of the metacarpophalangeal joints of the fingers: part II. Detection of simulated injuries in cadavers

PURPOSE: To evaluate and compare conventional magnetic resonance (MR) imaging and MR arthrography in the diagnosis of the most common traumatic metacarpophalangeal (MCP) joint injuries, which were created surgically in cadavers. MATERIALS AND METHODS: Injuries to various MCP joint structures were surgically created randomly in 28 fingers of seven human cadaveric hands. Injuries to the main collateral ligaments (CLs) (n = 12), accessory CL (n = 15), sagittal band (n = 14), transverse fibers of the extensor hood (n = 5), first annular pulley (n = 16), deep transverse metacarpal ligament (DTML) (n = 5), and palmar plate (n = 10) were analyzed. Conventional MR images and MR arthrograms were evaluated, with differences in interpretation resolved in consensus. The sensitivities, specificities, and accuracies of both MR imaging methods were determined, and the differences were tested for significance by using the McNemar test. RESULTS: Sensitivity was 28.6%-93.8% with conventional MR imaging versus 50.0%-93.3% with MR arthrography. Specificity was 66.7%-100% with conventional MR imaging versus 83.3%-100% with MR arthrography. Although the MR arthrographic results usually were higher, the differences were not significant. The kappa values for interobserver agreement were 0.314-0.638 for conventional MR imaging versus 0.364-1.00 for MR arthrography. Sensitivity for the detection of lesions of the main and accessory CLs and the first annular pulley was slightly higher than that for the detection of lesions of the extensor hood, DTML, and palmar plate structures. CONCLUSION: MR imaging and MR arthrography enable the diagnosis of simulated MCP joint injuries. MR arthrography does not have a significant advantage over conventional MR imaging