Longterm survey (7 years) in a population at risk for Lyme borreliosis: what happens to the seropositive individuals?

In 1986, a 26% seroprevalence of IgG- anti-Borrelia burgdorferi antibodies was observed among 950 orienteers and the incidence of new clinical infections was 0.8%. In 1993, a total of 305 seropositive orienteers were reexamined. During that time, 15 cases (4.9%) of definite/probable Lyme disease occurred in this seropositive group (12 skin manifestations and 3 monoarticular joint manifestations). Among the 12 definite cases, 9 showed new clinical infections (7 EM, 1 acrodermatitis chronica atrophicans, 1 arthritis), and 3 were recurrent (2 EM, 1 arthritis). The annual incidence (0.8%) in this seropositive group was identical to the incidence observed among the whole population in 1986. The individual antibody titer decreased slightly but the seroreversion rate was low (7%). Serology was not very helpful in identifying clinical cases and evolutions, and it can be stated, that a positive serology is much more frequent in this risk group than clinical disease

Longitudinal study of Lyme borreliosis in a high risk population in Switzerland

Orienteers from all parts of Switzerland (n = 416) were included in a longitudinal study for Lyme borreliosis. In spring 1986, the seroprevalence was 28.1 %. At the beginning of the study, 84.3 % of orienteers reported a history of tick bite, and 3.8 % reported a past history of Lyme borreliosis. During the first (spring 1986-autumn 1986), second (autumn 1986-spring 1987) and third (spring 1987-autumn 1987) period, rates of seroconversion were 0.6 %, 2.7 % and 2.1 % respectively. During the first and second period, clinical incidence were 1.0 % and 0.25 % respectively. No active Lyme borreliosis was detected during the third period. Among orienteers who seroconverted during the study (n = 16), only two developed clinical symptoms. Hence, Borrelia burgdorferi infection is often asymptomatic

A rat model of picornavirus-induced airway infection and inflammation

<p>Abstract</p> <p>Background</p> <p>Infection of the lower airways by rhinovirus, a member of the picornavirus family, is an important cause of wheezing illnesses in infants, and plays an important role in the pathogenesis of rhinovirus-induced asthma exacerbations. Given the absence of natural rhinovirus infections in rodents, we investigated whether an attenuated form of mengovirus, a picornavirus whose wild-type form causes systemic rather than respiratory infections in its natural rodent hosts, could induce airway infections in rats with inflammatory responses similar to those in human rhinovirus infections.</p> <p>Results</p> <p>After inoculation with 10⁷plaque-forming units of attenuated mengovirus through an inhalation route, infectious mengovirus was consistently recovered on days 1 and 3 postinoculation from left lung homogenates (median Log₁₀plaque-forming units = 6.0 and 4.8, respectively) and right lung bronchoalveolar lavage fluid (median Log₁₀plaque-forming units = 5.8 and 4.0, respectively). Insufflation of attenuated mengovirus, but not vehicle or UV-inactivated virus, into the lungs of BN rats caused significant increases <it>(P </it>< 0.05) in lower airway neutrophils and lymphocytes in the bronchoalveolar lavage fluid and patchy peribronchiolar, perivascular, and alveolar cellular infiltrates in lung tissue sections. In addition, infection with attenuated mengovirus significantly increased (<it>P </it>< 0.05) lower airway levels of neutrophil chemoattractant CXCR2 ligands [cytokine-induced neutrophil chemoattractant-1 (CINC-1; CXCL1) and macrophage inflammatory protein-2 (MIP-2; CXCL2)] and monocyte chemoattractant protein-1 (MCP-1; CCL2) in comparison to inoculation with vehicle or UV-inactivated virus.</p> <p>Conclusion</p> <p>Attenuated mengovirus caused a respiratory infection in rats with several days of viral shedding accompanied by a lower airway inflammatory response consisting of neutrophils and lymphocytes. These features suggest that mengovirus-induced airway infection in rodents could be a useful model to define mechanisms of rhinovirus-induced airway inflammation in humans.</p

Effects of Vitamin D on Airway Epithelial Cell Morphology and Rhinovirus Replication

Vitamin D has been linked to reduced risk of viral respiratory illness. We hypothesized that vitamin D could directly reduce rhinovirus (RV) replication in airway epithelium. Primary human bronchial epithelial cells (hBEC) were treated with vitamin D, and RV replication and gene expression were evaluated by quantitative PCR. Cytokine/chemokine secretion was measured by ELISA, and transepithelial resistance (TER) was determined using a voltohmmeter. Morphology was examined using immunohistochemistry. Vitamin D supplementation had no significant effects on RV replication, but potentiated secretion of CXCL8 and CXCL10 from infected or uninfected cells. Treatment with vitamin D in the form of 1,25(OH)2D caused significant changes in cell morphology, including thickening of the cell layers (median of 46.5 µm [35.0–69.0] vs. 30 µm [24.5–34.2], p<0.01) and proliferation of cytokeratin-5-expressing cells, as demonstrated by immunohistochemical analysis. Similar effects were seen for 25(OH)D. In addition to altering morphology, higher concentrations of vitamin D significantly upregulated small proline-rich protein (SPRR1β) expression (6.3 fold-induction, p<0.01), suggestive of squamous metaplasia. Vitamin D treatment of hBECs did not alter repair of mechanically induced wounds. Collectively, these findings indicate that vitamin D does not directly affect RV replication in airway epithelial cells, but can influence chemokine synthesis and alters the growth and differentiation of airway epithelial cells

System Noise Assessment and the Potential for a Low Noise Hybrid Wing Body Aircraft with Open Rotor Propulsion

An aircraft system noise assessment was conducted for a hybrid wing body freighter aircraft concept configured with three open rotor engines. The primary objective of the study was to determine the aircraft system level noise given the significant impact of installation effects including shielding the open rotor noise by the airframe. The aircraft was designed to carry a payload of 100,000 lbs on a 6,500 nautical mile mission. An experimental database was used to establish the propulsion airframe aeroacoustic installation effects including those from shielding by the airframe planform, interactions with the control surfaces, and additional noise reduction technologies. A second objective of the study applied the impacts of projected low noise airframe technology and a projection of advanced low noise rotors appropriate for the NASA N+2 2025 timeframe. With the projection of low noise rotors and installation effects, the aircraft system level was 26.0 EPNLdB below Stage 4 level with the engine installed at 1.0 rotor diameters upstream of the trailing edge. Moving the engine to 1.5 rotor diameters brought the system level noise to 30.8 EPNLdB below Stage 4. At these locations on the airframe, the integrated level of installation effects including shielding can be as much as 20 EPNLdB cumulative in addition to lower engine source noise from advanced low noise rotors. And finally, an additional set of technology effects were identified and the potential impact at the system level was estimated for noise only without assessing the impact on aircraft performance. If these additional effects were to be included it is estimated that the potential aircraft system noise could reach as low as 38.0 EPNLdB cumulative below Stage 4

Assessment of the Performance Potential of Advanced Subsonic Transport Concepts for NASA's Environmentally Responsible Aviation Project

NASA's Environmentally Responsible Aviation (ERA) project has matured technologies to enable simultaneous reductions in fuel burn, noise, and nitrogen oxide (NOx) emissions for future subsonic commercial transport aircraft. The fuel burn reduction target was a 50% reduction in block fuel burn (relative to a 2005 best-in-class baseline aircraft), utilizing technologies with an estimated Technology Readiness Level (TRL) of 4-6 by 2020. Progress towards this fuel burn reduction target was measured through the conceptual design and analysis of advanced subsonic commercial transport concepts spanning vehicle size classes from regional jet (98 passengers) to very large twin aisle size (400 passengers). Both conventional tube-and-wing (T+W) concepts and unconventional (over-wing-nacelle (OWN), hybrid wing body (HWB), mid-fuselage nacelle (MFN)) concepts were developed. A set of propulsion and airframe technologies were defined and integrated onto these advanced concepts which were then sized to meet the baseline mission requirements. Block fuel burn performance was then estimated, resulting in reductions relative to the 2005 best-in-class baseline performance ranging from 39% to 49%. The advanced single-aisle and large twin aisle T+W concepts had reductions of 43% and 41%, respectively, relative to the 737-800 and 777-200LR aircraft. The single-aisle OWN concept and the large twin aisle class HWB concept had reductions of 45% and 47%, respectively. In addition to their estimated fuel burn reduction performance, these unconventional concepts have the potential to provide significant noise reductions due, in part, to engine shielding provided by the airframe. Finally, all of the advanced concepts also have the potential for significant NOx emissions reductions due to the use of advanced combustor technology. Noise and NOx emissions reduction estimates were also generated for these concepts as part of the ERA project

Detection of Pathogenic Bacteria During Rhinovirus Infection is Associated with Increased Respiratory Symptoms and Exacerbations of Asthma

Background Detection of either viral or bacterial pathogens is associated with wheezing in children, however the influence of both bacteria and virus on illness symptoms has not been described. Objective We evaluated bacterial detection during peak RV season in children with and without asthma to determine if an association exists between bacterial infection and the severity of RV illnesses. Methods 308 children (166 with asthma, 142 without asthma) ages 4–12 years provided five consecutive weekly nasal samples during September, and scored cold and asthma symptoms daily. Viral diagnostics and quantitative PCR for Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis were performed on all nasal samples. Results Detection rates were 53%, 17% and 11% for H. influenzae, S. pneumoniae and M. catarrhalis, respectively, with detection of RV increasing the risk of detecting bacteria within the same sample (OR 2.0, 95% CI 1.4–2.7, p<0.0001) or the following week (OR 1.6 (1.1–2.4), p=0.02). In the absence of RV, S. pneumoniae was associated with increased cold symptoms (mean 2.7 (95% CI 2.0–3.5) vs. 1.8 (1.5–2.2), p=0.006) and moderate asthma exacerbations (18% (12%–27%) vs. 9.2% (6.7%–12%), p=0.006). In the presence of RV, S. pneumoniae was associated with increased moderate asthma exacerbations (22% (16%–29%) vs. 15% (11%–20%), p=0.01). Furthermore, M. catarrhalis detected alongside RV increased the likelihood of experiencing cold and/or asthma symptoms compared to isolated detection of RV (OR 2.0 (1.0–4.1), p=0.04). Regardless of RV status, H. influenzae was not associated with respiratory symptoms. Conclusion RV infection enhances detection of specific bacterial pathogens in children with and without asthma. Furthermore, these findings suggest that M. catarrhalis and S. pneumoniae contribute to the severity of respiratory illnesses, including exacerbations of asthma

Effects of dog ownership in early childhood on immune development and atopic diseases

Summary Background Exposure to pets in childhood has been associated with a reduced risk of wheezing and atopy. Objective Our objective was to determine whether the effects of pet exposure on immune development and atopy in early childhood can be explained by alterations in exposure to innate immune stimuli in settled dust. Methods Two hundred and seventy-five children at increased risk of developing allergic diseases were evaluated to age 3 years for pet ownership, blood cell cytokine responses, and atopy. Can f 1, Fel d 1, endotoxin, ergosterol, and muramic acid were measured in settled dust from 101 homes. Results Dog exposure at birth was associated with decreased atopic dermatitis (AD) (12% vs. 27%; P = 0.004) and wheezing (19% vs. 36%; P = 0.005) in year 3. The rates of AD (23%) and wheezing (42%) in year 3 were relatively high in children who acquired dogs after birth. The prevalence of dog sensitization (10-12%) did not vary according to dog exposure. Can f 1 levels in bedroom dust were positively associated with IL-10 (r = 0.26; P = 0.01), IL-5 (r = 0.34, P o 0.001), and IL-13 (r = 0.28; P = 0.004) responses at age 1, and IL-5 (r = 0.24; P = 0.022) and IL-13 (r = 0.25; P = 0.015) responses at age 3. In contrast, endotoxin was associated with IFN-g (r = 0.31; P = 0.002) and IL-13 (r = 0.27; P = 0.01) responses at age 3 but not at age 1, and similar relationships were present for muramic acid. Adjustment for levels of innate immune stimuli in house dust did not significantly affect the relationships between Can f 1 and cytokine responses. Conclusions Exposure to dogs in infancy, and especially around the time of birth, is associated with changes in immune development and reductions in wheezing and atopy. These findings are not explained by exposure to endotoxin, ergosterol, or muramic acid

Toll-like receptor 3 blockade in rhinovirus-induced experimental asthma exacerbations:A Randomized Controlled Study

BACKGROUND: Human rhinoviruses (HRVs) commonly precipitate asthma exacerbations. Toll-like receptor 3, an innate pattern recognition receptor, is triggered by HRV, driving inflammation that can worsen asthma. OBJECTIVE: We sought to evaluate an inhibitory mAb to Toll-like receptor 3, CNTO3157, on experimental HRV-16 inoculation in healthy subjects and asthmatic patients. METHODS: In this double-blind, multicenter, randomized, parallel-group study in North America and Europe, healthy subjects and patients with mild-to-moderate stable asthma received single or multiple doses of CNTO3157 or placebo, respectively, and were then inoculated with HRV-16 within 72 hours. All subjects were monitored for respiratory symptoms, lung function, and nasal viral load. The primary end point was maximal decrease in FEV1 during 10 days after inoculation. RESULTS: In asthmatic patients (n = 63) CNTO3157 provided no protection against FEV1 decrease (least squares mean: CNTO3157 [n = 30] = -7.08% [SE, 8.15%]; placebo [n = 25] = -5.98% [SE, 8.56%]) or symptoms after inoculation. In healthy subjects (n = 12) CNTO3157 versus placebo significantly attenuated upper (P = .03) and lower (P = .02) airway symptom scores, with area-under-the-curve increases of 9.1 (15.1) versus 34.9 (17.6) and 13.0 (18.4) versus 50.4 (25.9) for the CNTO3157 (n = 8) and placebo (n = 4) groups, respectively, after inoculation. All of the severe and 4 of the nonserious asthma exacerbations occurred while receiving CNTO3157. CONCLUSION: In summary, CNTO3157 was ineffective in attenuating the effect of HRV-16 challenge on lung function, asthma control, and symptoms in asthmatic patients but suppressed cold symptoms in healthy subjects. Other approaches, including blockade of multiple pathways or antiviral agents, need to be sought for this high unmet medical need