MyD88 Signaling Regulates Steady-State Migration of Intestinal CD103⁺Dendritic Cells Independently of TNF-α and the Gut Microbiota

Intestinal homeostasis and induction of systemic tolerance to fed Ags (i.e., oral tolerance) rely on the steady-state migration of small intestinal lamina propria dendritic cells (DCs) into draining mesenteric lymph nodes (MLN). The majority of these migratory DCs express the α integrin chain CD103, and in this study we demonstrate that the steady-state mobilization of CD103(+) DCs into the MLN is in part governed by the IL-1R family/TLR signaling adaptor molecule MyD88. Similar to mice with complete MyD88 deficiency, specific deletion of MyD88 in DCs resulted in a 50-60% reduction in short-term accumulation of both CD103(+)CD11b(+) and CD103(+)CD11b(-) DCs in the MLN. DC migration was independent of caspase-1, which is responsible for the inflammasome-dependent proteolytic activation of IL-1 cytokine family members, and was not affected by treatment with broad-spectrum antibiotics. Consistent with the latter finding, the proportion and phenotypic composition of DCs were similar in mesenteric lymph from germ-free and conventionally housed mice. Although TNF-α was required for CD103(+) DC migration to the MLN after oral administration of the TLR7 agonist R848, it was not required for the steady-state migration of these cells. Similarly, TLR signaling through the adaptor molecule Toll/IL-1R domain-containing adapter inducing IFN-β and downstream production of type I IFN were not required for steady-state CD103(+) DC migration. Taken together, our results demonstrate that MyD88 signaling in DCs, independently of the microbiota and TNF-α, is required for optimal steady-state migration of small intestinal lamina propria CD103(+) DCs into the MLN

Fishing Livelihoods as Key to Marine Protected Areas: Insights from the World Parks Congress

Marine protected areas (MPAs) have become a widely used tool for marine conservation and fisheries management. In coastal areas, it has become clear that the success of MPAs, and the achievement of sustainable fishery production, requires a combination of effective management and conservation frameworks, maintenance of decent fisheries livelihoods, and effective participation of coastal communities, fishing people, and other ocean users in considering, designing and implementing MPAs. These ingredients are crucial to provide the social sustainability needed to achieve ecological sustainability, and in particular, to reconcile fisheries and marine conservation objectives, in light of the United Nations Sustainable Development Goals and Aichi targets of the Convention on Biological Diversity (CBD). The 2014 World Parks Congress in Sydney reinforced the apparent movement towards recognition of social and economic issues related to MPAs, including the importance of food security and livelihoods, and the crucial nature of interactions between MPAs and fisheries. Many discussions at the 2014 WPC focused on these human dimensions of MPAs, and the need to incorporate them into MPA decision-making, but the meeting as a whole highlighted concerns over several issues, such as the advocacy of a specific area-based MPA target globally. This presentation examines the WPC outcomes, with emphasis on the role of people (in particular, fishers) in marine conservation and coastal MPAs, and explores potential strategies for moving constructively beyond the still existing tensions between environment- and people-focused conservation and development.Proceedings of the Eighteenth Biennial Conference of the International Institute of Fisheries Economics and Trade, held July 11-15, 2016 at Aberdeen Exhibition and Conference Center (AECC), Aberdeen, Scotland, UK

Experiences of Patients With Atrial Fibrillation With Combination Antithrombotic Therapy Post–Percutaneous Coronary Intervention

Background: Up to 30% of patients with atrial fibrillation (AF) have coronary artery disease, and many undergo percutaneous coronary intervention (PCI). In the setting of acute coronary syndrome with PCI, or high-risk elective PCI, Canadian AF guidelines recommend 1-30 days of acetylsalicylic acid, 1-12 months of clopidogrel, and oral anticoagulation (OAC) with doses that may change throughout the 12 months post-PCI. The complexity of these regimens may contribute to unplanned modifications (UPMs), increasing the risk of thrombosis and/or bleeding. We describe what happens to these patients and their antithrombotic therapy (ATT) after discharge. Methods: Prospective follow-up was conducted of patients with AF requiring OAC who underwent PCI and were discharged on combination ATT. Patients were contacted at 1, 3, 6, and 12 months post-PCI. Results: Sixty-five patients were enrolled, with data at any time point available for 61 of them (94%). Of these, 44 (68%) experienced at least one UPM to ATT. In total, 105 UPMs occurred. The most common UPM was an extended duration of P2Y12 inhibitor (23 instances; 22%). The most common UPM with acetylsalicylic acid was extended (11 instances; 11%) or shortened (11 instances; 11%) duration. Thirty-nine UPMs (37%) were related to OACs; 9 (23%) were related to warfarin, and 30 (77%) were related to direct OACs. Of all patients with at least one UPM, 33 (75%) experienced bleeding. Conclusions: More than 2 in 3 patients with AF undergoing PCI experienced a UPM to their ATT. This study underscores the challenges of combination ATT for patients and clinicians alike, emphasizing the need for patient support after discharge. Résumé: Contexte: Jusqu’à 30 % des patients atteints de fibrillation auriculaire (FA) ont une coronaropathie, et nombre d’entre eux doivent subir une intervention coronarienne percutanée (ICP). En présence d’un syndrome coronarien aigu nécessitant une ICP ou dans le cas d’une ICP non urgente associée à un risque élevé, on recommande, dans les lignes directrices canadiennes sur la FA, un traitement de 1 à 30 jours par l’acide acétylsalicylique, de 1 à 12 mois par le clopidogrel, et une anticoagulothérapie orale (ACO) à des doses pouvant varier durant les 12 mois suivant l’ICP. La complexité de ces schémas posologiques peut contribuer à des modifications non planifiées (MNP) du traitement, ce qui accroît le risque de thrombose et/ou de saignement. Nous décrivons ce qui advient de ces patients et de leur traitement antithrombotique (TAT) après le congé de l’hôpital. Méthodologie: Un suivi prospectif a été réalisé chez des patients atteints de FA nécessitant une ACO, ayant subi une ICP et recevant un TAT lors de leur congé de l’hôpital. Les patients ont été contactés 1, 3, 6 et 12 mois après leur ICP. Résultats: Parmi les soixante-cinq patients inscrits, des données ont été obtenues pour 61 d’entre eux (94 %) à un moment ou à un autre. Au moins une MNP du TAT a eu lieu chez 44 (68 %) de ces 61 patients, pour un total de 105 MNP. La MNP la plus fréquente était la prolongation de la durée du traitement par un inhibiteur du P2Y12 (23 cas, soit 22 %). La MNP la plus fréquente du traitement par l’acide acétylsalicylique était la prolongation (11 cas, soit 11 %) ou le raccourcissement (11 cas, soit 11 %) de la durée du traitement. Au total, 39 MNP (37 %) étaient liées à des anticoagulants oraux, 9 (23 %) à la warfarine et 30 (77 %) à des anticoagulants oraux directs. Sur l’ensemble des patients ayant fait l’objet d’au moins une MNP, 33 (75 %) ont subi un saignement. Conclusions: Une MNP du TAT a eu lieu chez plus des deux tiers des patients atteints de FA ayant subi une ICP. Cette étude souligne les difficultés que pose un TAT d’association, tant pour les patients que pour les médecins, ce qui met en évidence la nécessité d’accompagner les patients après leur congé de l’hôpital

The role of MPAs in reconciling fisheries management with conservation of biological diversity

A workshop of over 100 participants, balanced between fisheries management and biodiversity conservation backgrounds, reviewed and synthesised experiences regarding policy and institutional frameworks for use of MPAs in the contexts of fisheries management and conservation of biological diversity. The workshop concluded that although fisheries managers and biodiversity conservation agencies may give differing and sometimes opposing weights to the many objectives that could be set for MPAs, only 25% of fisheries objectives and 30% of biodiversity objectives were considered to be potential sources of conflict. MPAs that segregate activities in space could contribute to resolving all but one of the potential conflicts over objectives associated with desired ecological outcomes. Conflicts over social or economic objectives could be improved, made worse, or not be affected by MPAs, depending on how the MPAs were developed and managed. Seven features of planning processes and six features of the governance processes for MPAs were identified that could help find broadly supported solutions to the conflicts that did occur. Once established, the management of the MPA should be inclusive and participatory, as well as continuously learning and adaptive. Approaches to ensure management had those properties were identified, including twelve specific mechanisms that should be available to the MPA managers. On the basis of these conclusions about objectives, planning, and management, a general framework for the governance of MPAs for both fisheries and biodiversity conservation was developed. Its ten general characteristics and twelve steps necessary for progress were identified. We discuss the special challenges of establishing and managing MPAs for fisheries and biodiversity conservation on the high seas that deserve further attention include information-sharing, coordination and defining jurisdictions and stake-holding