164 research outputs found

    Vegetation and Flora of the Sand Deposits of the Mississippi River Valley in Northwestern Illinois

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    This study was undertaken to determine vascular plant species composition, vegetation structure, and floristic quality of the major plant communities in the windblown sand deposits of northwestern Illinois during the growing seasons of 2002 through 2005. The major plant communities of the Ayers Sand Prairie Nature Preserve in Carroll County, Big River State Forest in Henderson County, Lost Mound Unit of the Upper Mississippi River Wildlife and Fish Refuge in Carroll and Jo Daviess counties, and the Thomson-Fulton Sand Prairie Nature Preserve located in Whiteside County were examined and the importance values determined for the plant species present. Located on broad terraces of the Mississippi River, these nature preserves and natural areas are remnants of a larger grassland/savanna/forest complex that contained extensive marsh; wet, mesic, and dry sand prairie; sand savanna; and sand forest communities. Most of the sand deposits are now cultivated and the original vegetation is found only in protected remnants, some of which are relatively large. The mature dry sand prairies were dominated by Schizachyrium scoparium; other important species were Opuntia macrorhiza, Dichanthelium villosissimum, Ambrosia psilostachya, and Tephrosia virginiana. Other assemblages of prairie and exotic species were encountered in successional sand prairie communities. Generally, the mature prairie communities in these preserves and natural areas had 35 or more species present in the study plots. Savanna and closed canopy forest communities were also examined. The dry sand savannas were dominated by Quercus velutina and Q. marilandica, dry sand forests were dominated by Q. velutina, and dry-mesic sand forests were dominated by Q. alba and Q. velutina.Illinois Department of Natural Resources; Illinois Nature Preserves Commissionpublished or submitted for publicationis peer reviewe

    Therapy prolongation improves outcome in multisystem Langerhans cell histiocytosis

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    Key Points Reactivations of multisystem Langerhans cell histiocytosis (MS-LCH) are reduced by prolonging initial chemotherapy. The previously high mortality of high-risk (risk-organ–positive) MS-LCH in children has been markedly reduced

    Stem cell transplantation for children with hemophagocytic lymphohistiocytosis: results from the HLH-2004 study

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    We report the largest prospective study thus far on hematopoietic stem cell transplantation (HSCT) in hemophagocytic lymphohistiocytosis (HLH), a life-threatening hyperinflammatory syndrome comprising familial/genetic HLH (FHL) and secondary HLH. Although all patients with HLH typically need intensive anti-inflammatory therapy, patients with FHL also need HSCT to be cured. In the international HLH-2004 study, 187 children aged ,18 years fulfilling the study inclusion criteria (5 of 8 diagnostic criteria, affected sibling, or molecular diagnosis in FHL-causative genes) underwent 209 transplants (2004-2012), defined as indicated in patients with familial/genetic, relapsing, or severe/persistent disease. Five-year overall survival (OS) post-HSCT was 66% (95% confidence interval [CI], 59-72); event-free survival (EFS) was 60% (95% CI, 52-67). Five-year OS was 81% (95% CI, 65-90) for children with a complete response and 59% (95% CI, 48-69) for those with a partial response (hazard ratio [HR], 2.12; 95% CI, 1.06-4.27; P 5 .035). For children with verified FHL (family history/genetically verified, n 5 134), 5-year OS was 71% (95% CI, 62-78) and EFS was 62% (95% CI, 54-70); 5-year OS for children without verified FHL (n 5 53) was significantly lower (52%; 95% CI, 38-65) (P 5 .040; HR, 1.69; 95% CI, 1.03-2.77); they were also significantly older. Notably, 20 (38%) of 53 patients without verified FHL had natural killer cell activity reported as normal at diagnosis, after 2 months, or at HSCT, suggestive of secondary HLH; and in addition 14 (26%) of these 53 children had no evidence of biallelic mutations despite having 3 or 4 FHL genes analyzed (natural killer cell activity not analyzed after 2 months or at HSCT). We conclude that post-HSCT survival in FHL remains suboptimal, and that the FHL diagnosis should be carefully investigated before HSCT. Pretransplant complete remission is beneficial but not mandatory to achieve post-HSCT survival.Fil: Bergsten, Elisabet. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Horne, AnnaCarin. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Hed Myrberg, Ida. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Aricó, Maurizio. Children Hospital Giovanni XXIII; ItaliaFil: Astigarraga, Itziar. Universidad del País Vasco; EspañaFil: Ishii, Eiichi. Ehime University; JapónFil: Janka, Gritta. Universitat Hamburg; AlemaniaFil: Ladisch, Stephan. Children’s National Medical Center; Estados UnidosFil: Lehmberg, Kai. Universitat Hamburg; AlemaniaFil: McClain, Kenneth L.. Baylor College of Medicine; Estados UnidosFil: Minkov, Milen. Universidad de Viena; AustriaFil: Nanduri, Vasanta. Watford General Hospital; Reino UnidoFil: Rosso, Diego. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sieni, Elena. Universitaria A. Meyer Children Hospital; ItaliaFil: Winiarski, Jacek. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Henter, Jan Inge. Karolinska Huddinge Hospital. Karolinska Institutet; Sueci

    Hematopoietic origin of Langerhans cell histiocytosis and Erdheim-Chester disease in adults.

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    Langerhans cell histiocytosis (LCH) and Erdheim-Chester disease (ECD) are rare histiocytic disorders induced by somatic mutation of MAPK pathway genes. BRAFV600E mutation is the most common mutation in both conditions and also occurs in the hematopoietic neoplasm hairy cell leukemia (HCL). It is not known if adult LCH or ECD arises from hematopoietic stem cells (HSCs), nor which potential blood borne precursors lead to the formation of histiocytic lesions. In this study, BRAFV600E allele-specific polymerase chain reaction was used to map the neoplastic clone in 20 adults with LCH, ECD, and HCL. BRAFV600E was tracked to classical monocytes, nonclassical monocytes, and CD1c+ myeloid dendritic cells (DCs) in the blood, and mutations were observed in HSCs and myeloid progenitors in the bone marrow of 4 patients. The pattern of involvement of peripheral blood myeloid cells was indistinguishable between LCH and ECD, although the histiocytic disorders were distinct to HCL. As reported in children, detection of BRAFV600E in peripheral blood of adults was a marker of active multisystem LCH. The healthy counterparts of myeloid cells affected by BRAF mutation had a range of differentiation potentials depending on exogenous signals. CD1c+ DCs acquired high langerin and CD1a with granulocyte-macrophage colony-stimulating factor and transforming growth factor β alone, whereas CD14+ classical monocytes required additional notch ligation. Both classical and nonclassical monocytes, but not CD1c+ DCs, made foamy macrophages easily in vitro with macrophage colony-stimulating factor and human serum. These studies are consistent with a hematopoietic origin and >1 immediate cellular precursor in both LCH and ECD

    Low dose chloroquine decreases insulin resistance in human metabolic syndrome but does not reduce carotid intima-media thickness

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    Background: Metabolic syndrome, an obesity-related condition associated with insulin resistance and low-grade inflammation, leads to diabetes, cardiovascular diseases, cancer, osteoarthritis, and other disorders. Optimal therapy is unknown. The antimalarial drug chloroquine activates the kinase ataxia telangiectasia mutated (ATM), improves metabolic syndrome and reduces atherosclerosis in mice. To translate this observation to humans, we conducted two clinical trials of chloroquine in people with the metabolic syndrome. Methods: Eligibility included adults with at least 3 criteria of metabolic syndrome but who did not have diabetes. Subjects were studied in the setting of a single academic health center. The specific hypothesis: chloroquine improves insulin sensitivity and decreases atherosclerosis. In Trial 1, the intervention was chloroquine dose escalations in 3-week intervals followed by hyperinsulinemic euglycemic clamps. Trial 2 was a parallel design randomized clinical trial, and the intervention was chloroquine, 80 mg/day, or placebo for 1 year. The primary outcomes were clamp determined-insulin sensitivity for Trial 1, and carotid intima-media thickness (CIMT) for Trial 2. For Trial 2, subjects were allocated based on a randomization sequence using a protocol in blocks of 8. Participants, care givers, and those assessing outcomes were blinded to group assignment. Results: For Trial 1, 25 patients were studied. Chloroquine increased hepatic insulin sensitivity without affecting glucose disposal, and improved serum lipids. For Trial 2, 116 patients were randomized, 59 to chloroquine (56 analyzed) and 57 to placebo (51 analyzed). Chloroquine had no effect on CIMT or carotid contrast enhancement by MRI, a pre-specified secondary outcome. The pre-specified secondary outcomes of blood pressure, lipids, and activation of JNK (a stress kinase implicated in diabetes and atherosclerosis) were decreased by chloroquine. Adverse events were similar between groups. Conclusions: These findings suggest that low dose chloroquine, which improves the metabolic syndrome through ATM-dependent mechanisms in mice, modestly improves components of the metabolic syndrome in humans but is unlikely to be clinically useful in this setting

    Circulating senescent myeloid cells drive blood brain barrier breakdown and neurodegeneration

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    Neurodegenerative diseases (ND) are characterized by progressive loss of neuronal function. Mechanisms of ND pathogenesis are incompletely understood, hampering the development of effective therapies. Langerhans cell histiocytosis (LCH) is an inflammatory neoplastic disorder caused by hematopoietic progenitors expressing MAPK activating mutations that differentiate into senescent myeloid cells that drive lesion formation. Some patients with LCH subsequently develop progressive and incurable neurodegeneration (LCH-ND). Here, we show that LCH-ND is caused by myeloid cells that are clonal with peripheral LCH cells. We discovered that circulating BRAF V600E +^{+} myeloid cells cause the breakdown of the blood-brain barrier (BBB), enhancing migration into the brain parenchyma where they differentiate into senescent, inflammatory CD11a +^{+} macrophages that accumulate in the brainstem and cerebellum. Blocking MAPK activity and senescence programs reduced parenchymal infiltration, neuroinflammation, neuronal damage and improved neurological outcome in preclinical LCH-ND. MAPK activation and senescence programs in circulating myeloid cells represent novel and targetable mechanisms of ND
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