Haematopoietic stem cell-derived immune cells have reduced X chromosome inactivation skewing in systemic lupus erythematosus

Objectives: Systemic lupus erythematosus (SLE) shows a marked female bias in prevalence. X chromosome inactivation (XCI) is the mechanism which randomly silences one X chromosome to equalise gene expression between 46, XX females and 46, XY males. Though XCI is expected to result in a random pattern of mosaicism across tissues, some females display a significantly skewed ratio in immune cells, termed XCI-skew. We tested whether XCI was abnormal in females with SLE and hence contributes to sexual dimorphism. Methods: We assayed XCI in whole blood DNA in 181 female SLE cases, 796 female healthy controls and 10 twin pairs discordant for SLE. Using regression modelling and intra-twin comparisons, we assessed the effect of SLE on XCI and combined clinical, cellular and genetic data via a polygenic score to explore underlying mechanisms. Results: Accommodating the powerful confounder of age, XCI-skew was reduced in females with SLE compared with controls (p=1.3×10 -5), with the greatest effect seen in those with more severe disease. Applying an XCI threshold of &gt;80%, we observed XCI-skew in 6.6% of SLE cases compared with 22% of controls. This difference was not explained by differential white cell counts, medication or genetic susceptibility to SLE. Instead, XCI-skew correlated with a biomarker for type I interferon-regulated gene expression. Conclusions: These results refute current views on XCI-skew in autoimmunity and suggest, in lupus, XCI patterns of immune cells reflect the impact of disease state, specifically interferon signalling, on the haematopoietic stem cells from which they derive.</p

The plasma biomarker soluble SIGLEC-1 is associated with the type I interferon transcriptional signature, ethnic background and renal disease in systemic lupus erythematosus.

BACKGROUND: The molecular heterogeneity of autoimmune and inflammatory diseases has been one of the main obstacles to the development of safe and specific therapeutic options. Here, we evaluated the diagnostic and clinical value of a robust, inexpensive, immunoassay detecting the circulating soluble form of the monocyte-specific surface receptor sialic acid binding Ig-like lectin 1 (sSIGLEC-1). METHODS: We developed an immunoassay to measure sSIGLEC-1 in small volumes of plasma/serum from systemic lupus erythematosus (SLE) patients (n = 75) and healthy donors (n = 504). Samples from systemic sclerosis patients (n = 99) were studied as an autoimmune control. We investigated the correlation between sSIGLEC-1 and both monocyte surface SIGLEC-1 and type I interferon-regulated gene (IRG) expression. Associations of sSIGLEC-1 with clinical features were evaluated in an independent cohort of SLE patients (n = 656). RESULTS: Plasma concentrations of sSIGLEC-1 strongly correlated with expression of SIGLEC-1 on the surface of blood monocytes and with IRG expression in SLE patients. We found ancestry-related differences in sSIGLEC-1 concentrations in SLE patients, with patients of non-European ancestry showing higher levels compared to patients of European ancestry. Higher sSIGLEC-1 concentrations were associated with lower serum complement component 3 and increased frequency of renal complications in European patients, but not with the SLE Disease Activity Index clinical score. CONCLUSIONS: Our sSIGLEC-1 immunoassay provides a specific and easily assayed marker for monocyte-macrophage activation, and interferonopathy in SLE and other diseases. Further studies can extend its clinical associations and its potential use to stratify patients and as a secondary endpoint in clinical trials

Eigenvalues of Dirichlet Laplacian within the class of open sets with constant diameter

This paper is about a shape optimization problem related to the Dirichlet Laplacian eingevalues in the Euclidean plane. More precisely we study the shape of the minimizer in the class of open sets of constant width. We prove that the disk is not a local minimizer except for a limited number of eigenvalues

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Expression of vFLIP in a Lentiviral Vaccine Vector Activates NF-κB, Matures Dendritic Cells, and Increases CD8+ T-Cell Responses▿

Lentiviral vectors deliver antigens to dendritic cells (DCs) in vivo, but they do not trigger DC maturation. We therefore expressed a viral protein that constitutively activates NF-κB, vFLIP from Kaposi's sarcoma-associated herpesvirus (KSHV), in a lentivector to mature DCs. vFLIP activated NF-κB in mouse bone marrow-derived DCs in vitro and matured these DCs to a similar extent as lipopolysaccharide; costimulatory markers CD80, CD86, CD40, and ICAM-1 were upregulated and tumor necrosis factor alpha and interleukin-12 secreted. The vFLIP-expressing lentivector also matured DCs in vivo. When we coexpressed vFLIP in a lentivector with ovalbumin (Ova), we found an increased immune response to Ova; up to 10 times more Ova-specific CD8+ T cells secreting gamma interferon were detected in the spleens of vFLIP_Ova-immunized mice than in the spleens of mice immunized with GFP_Ova. Furthermore, this increased CD8+ T-cell response correlated with improved tumor-free survival in a tumor therapy model. A single immunization with vFLIP_Ova also reduced the parasite load when mice were challenged with OVA-Leishmania donovani. In conclusion, vFLIP from KSHV is a DC activator, maturing DCs in vitro and in vivo. This demonstrates that NF-κB activation is sufficient to induce many aspects of DC maturation and that expression of a constitutive NF-κB activator can improve the efficacy of a vaccine vector

EVALUATING THE ROLE OF IL-2 AND IL-6 IN PATIENTS WITH BURNS USING ELISA TECHNIQUE

Introduction: Burns are common medical infections that examined in hospitals. Cytokines are produced by innate immune response; cytokines determine the type of adaptive immune response. This study aims to screen and evaluate the role of IL-2 and IL-6 levels in the serum of patients who have suffered from burns by ELISA technique. Methods: Seventy serum samples were collected from burned patients in Baghdad city hospitals and tested by ELISA technique to detect IL-2 and IL-6 levels. Results: Shows great differences in IL-2 level of male patients (30.16 pg/ml) compared to males control group by an average of (29.66 pg/ml). While IL-6 shows significant differences in female patients with range (63.39 pg/ml) and male (66.47 pg/ml) compared to females control group (2.48 pg/ml) and males (22.80 pg/ml). Moreover cytokines shows significant differences between the three age groups of burned patients in comparison with the control group. In conclusion the result of present study showed significant difference in level of some cytokines IL-2,IL-6 for patients with burns. Conclusion: the result of present study showed significant difference in level of some cytokines IL-2, IL-6 for patients with burns

IMPROVING THE ANTIBACTERIAL ACTIVITY BY THE COMBINATION OF ZIRCONIUM OXIDE NANOPARTICLES (ZrO2) AND CEFTAZIDIME AGAINST KLEBSIELLA PNEUMONIAE

Introduction: Klebsilla pneumoniae is one of must opportunistic pathogens that causes nosocomial infection, UTI, respiratory tract infections and blood infections. ZrO2 nanoparticles have antimicrobial activity against some pathogenic bacteria and fungi. Ceftazidime is one of third generation cephalosporins groups of antibiotecs, characterized by its broad spectrum on bacteria in general and particularly on Enterobacteriaceae family like Klebsiella spp. Method: Diverse clinical samples of Klebsilla pneumoniae were isolated from several hospitals in Baghdad – Iraq and ZrO2 nanoparticles was investigated against it. Ceftazidime was also investigated against K. pneumoniae. Both of ZrO2 nanoparticles and ceftazidime were mixed together and investigated against K. pneumoniae. Results: The result showed that ZrO2 nanoparticles were effectivity on inhibiting opportunistic pathogens. By using zirconium oxide nanoparticles on Klebsiella pneumonia isolates in 24h. of incubation time, inhibition zones were (38,34,10,10,8,0) mm respectively on agar plates. By using ceftazidime alone against the same bacteria inhibition zones were (40,32,10,9,8,0) mm. respectively. Conclusion:The present study results that the antibacterial activity of ceftazidime against bacteria was increased when combination between ZrO2 nanoparticles and the antibiotic had done, because, inhibition zones in case of mixing both of ZrO2 nanoparticles and ceftazidime were (43,40,12,12,10,0) mm respectively. So that we can conclude that the combination of zirconium oxide nanoparticles (ZrO2) and ceftazidime was a useful method for the treatment of Klebsilla pneumonia that cause nosocomial infection, UTI, respiratory tract infections and blood infections