Decreased Th1-Type Inflammatory Cytokine Expression in the Skin Is Associated with Persisting Symptoms after Treatment of Erythema Migrans

Background: Despite the good prognosis of erythema migrans (EM), some patients have persisting symptoms of various character and duration post-treatment. Several factors may affect the clinical outcome of EM, e. g. the early interaction between Borrelia (B.) burgdorferi and the host immune response, the B. burgdorferi genotype, antibiotic treatment as well as other clinical circumstances. Our study was designed to determine whether early cytokine expression in the skin and in peripheral blood in patients with EM is associated with the clinical outcome. Methods: A prospective follow-up study of 109 patients with EM was conducted at the A land Islands, Finland. Symptoms were evaluated at 3, 6, 12 and 24 months post-treatment. Skin biopsies from the EM and healthy skin were immunohistochemically analysed for expression of interleukin (IL)-4, IL-10, IL-12p70 and interferon (IFN)-gamma, as well as for B. burgdorferi DNA. Blood samples were analysed for B. burgdorferi antibodies, allergic predisposition and levels of systemic cytokines. Findings: None of the patients developed late manifestations of Lyme borreliosis. However, at the 6-month follow-up, 7 of 88 patients reported persisting symptoms of diverse character. Compared to asymptomatic patients, these 7 patients showed decreased expression of the Th1-associated cytokine IFN-gamma in the EM biopsies (p = 0.003). B. afzelii DNA was found in 48%, B. garinii in 15% and B. burgdorferi sensu stricto in 1% of the EM biopsies, and species distribution was the same in patients with and without post-treatment symptoms. The two groups did not differ regarding baseline patient characteristics, B. burgdorferi antibodies, allergic predisposition or systemic cytokine levels. Conclusion: Patients with persisting symptoms following an EM show a decreased Th1-type inflammatory response in infected skin early during the infection, which might reflect a dysregulation of the early immune response. This finding supports the importance of an early, local Th1-type response for optimal resolution of LB.Original Publication: Johanna Sjöwall, Linda Fryland, Marika Nordberg, Florence Sjögren, Ulf Garpmo, Christian Jansson, Sten-Anders Carlsson, Sven Bergstrom, Jan Ernerudh, Dag Nyman, Pia Forsberg and Christina Ekerfelt, Decreased Th1-Type Inflammatory Cytokine Expression in the Skin Is Associated with Persisting Symptoms after Treatment of Erythema Migrans, 2011, PLOS ONE, (6), 3, 0018220. http://dx.doi.org/10.1371/journal.pone.0018220 Copyright: Public Library of Science (PLoS) http://www.plos.org

Medical proton dosimetry using radioluminescence from aluminium oxide crystals attached to optical-fiber cables

The prime objective of this study is to investigate if radioluminescence (RL) from carbon-doped aluminum oxide (Al2O3:C) crystals potentially can be used for absorbed dose-rate measurements during proton radiotherapy. The RL from two separate (2 mg) Al2O3:C crystals attached to optical-fiber cables were recorded during irradiations in water in a 175 MeV clinical proton beam. The RL response for low-LET protons in the plateau region of the Bragg curve was found to closely resemble that observed for a clinical 6 MV X-ray beam. An identical response was found in the Bragg peak (where the dose-averaged LET is about 4 keV/mu m) for absorbed doses less than 0.3 Gy. For doses in the range of 0.3-3Gy, we observed a significant decrease in luminescence efficiency with LET. At 3 Gy, the luminescence efficiency was about 60% in the Bragg-peak region. The study implies that the RL-signal from Al2O3:C could potentially be suitable for medical proton dosimetry in the 0-0.3 Gy range even without any LET-dependent correction factors. (C) 2007 Elsevier B.V. All rights reserved

EXPERIENCE OF CYCLOTRON OPERATION WITH BEAM SHARING AT TSL

Following a reorientation in 2005/2006, the focus of<br />activities at TSL was shifted from nuclear physics to<br />proton therapy and radiation testing with protons and<br />neutrons. In order to use the beam as efficient as possible<br />beam sharing is employed. The paper describes the<br />development of a range of control system utilities, for<br />example switching of the beam between users by the<br />principal user instead of being controlled via a cyclotron<br />operator.IMP;Chinese Academy of Science