Allergic Responses Induced by a Fungal Biopesticide Metarhizium anisopliae and House Dust Mite Are Compared in a Mouse Model

Biopesticides can be effective in controlling their target pest. However, research regarding allergenicity and asthma development is limited. We compared the ability of fungal biopesticide Metarhizium anisopliae (MACA) and house dust mite (HDM) extracts to induce allergic responses in BALB/c mice. The extracts were administered by intratracheal aspiration at doubling doses (2.5–80 μg protein) 4X over a four-week period. Three days after the last exposure, serum and bronchoalveolar lavage fluid (BALF) were collected. The extracts' relative allergenicity was evaluated based on response robustness (lowest significant dose response compared to control (0 μg)). MACA induced a more robust serum total IgE response than HDM. However, in the antigen-specific IgE assay, a similar dose of both MACA and HDM was required to achieve the same response level. Our data suggest a threshold dose of MACA for allergy induction and that M. anisopliae may be similar to HDM in allergy induction potential

Supervised Treatment Interruption (STI) in an Urban HIV Clinical Practice: A Prospective Analysis

Background: In acute HIV-1 infection, STI may induce immunologic control of HIV-1 replication. Several prospective trials of STI in chronic HIV-1 infection have been less encouraging. A previously presented retrospective analysis of our patients showed that in those with a significant CD4 increase (\u3e200 cells) on antiretroviral therapy (ART), 2 or more interruptions may significantly lower viral set point. This prospective study describes STI in a cohort of patients. Methods: 10 patients with either a positive response to therapy interruption retrospectively or those expressing interest in the strategy who met inclusion criteria (VL BLQ on ART, good adherence, robust CD4 response) were selected. Interruptions analyzed were prospective and supervised. Timing of STI cycles was based on CD4 and Viral Load (VL) responses not a predetermined schedule. Data collected included demographics, ART, VL, CD4, and illnesses during STI. Results: Of 7/10 patients with data at 4 weeks off ART, the mean VL was 1.78 log10 copies/ml below baseline (BL). In 10 patients \u3e 8 weeks off ART, the mean VL was 1.38 log10 below BL. 7/10 maintained VL 8 weeks off ART (mean 27 weeks, 1 \u3e 2 years). 4/7 with data during more than one STI showed an increase in time to reach 5000 copies/ml. None developed resistance-conferring mutations nor HIV-related illnesses during interruption. ART regimen or Hepatitis C seropositivity were not statistically significant factors affecting response to STI (durationΔVL; p\u3e0.05). Conclusions: Although no consensus exists concerning the effectiveness of STI in chronic HIV infection, a majority of our subjects were able to stop ART and maintain viral control for a period of time. Closely monitored STI was associated with lowered viral set point during the interruption in most cases. A larger prospective study is warranted but we recommend future trials measure additional parameters and avoid using the same STI schedule for all subjects

Development and validation of the brief esophageal dysphagia questionnaire

BackgroundEsophageal dysphagia is common in gastroenterology practice and has multiple etiologies. A complication for some patients with dysphagia is food impaction. A valid and reliable questionnaire to rapidly evaluate esophageal dysphagia and impaction symptoms can aid the gastroenterologist in gathering information to inform treatment approach and further evaluation, including endoscopy.Methods1638 patients participated over two study phases. 744 participants completed the Brief Esophageal Dysphagia Questionnaire (BEDQ) for phase 1; 869 completed the BEDQ, Visceral Sensitivity Index, Gastroesophageal Reflux Disease Questionnaire, and Hospital Anxiety and Depression Scale for phase 2. Demographic and clinical data were obtained via the electronic medical record. The BEDQ was evaluated for internal consistency, split‐half reliability, ceiling and floor effects, and construct validity.Key ResultsThe BEDQ demonstrated excellent internal consistency, reliability, and construct validity. The symptom frequency and severity scales scored above the standard acceptable cutoffs for reliability while the impaction subscale yielded poor internal consistency and split‐half reliability; thus the impaction items were deemed qualifiers only and removed from the total score. No significant ceiling or floor effects were found with the exception of 1 item, and inter‐item correlations fell within accepted ranges. Construct validity was supported by moderate yet significant correlations with other measures. The predictive ability of the BEDQ was small but significant.Conclusions & InferencesThe BEDQ represents a rapid, reliable, and valid assessment tool for esophageal dysphagia with food impaction for clinical practice that differentiates between patients with major motor dysfunction and mechanical obstruction.Validated, rapid clinical assessment tools for esophageal dysphagia are lacking. The brief esophageal dysphagia questionnaire aims to gauge the severity and frequency of dysphagia with additional items to gauge food impaction. The BEDQ is a reliable and valid tool to assess esophageal dysphagia.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135130/1/nmo12889.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135130/2/nmo12889_am.pd