EFFECTS OF INTERLEUKIN-22 (IL-22) ON NECROPTOSIS, INFLAMMATORY RESPONSES, AND METABOLISM OF MYCOBACTERIUM TUBERCULOSIS STIMULATED TYPE 2 DIABETES MELLITUS MOUSE MACROPHAGES

Mycobacterium tuberculosis (Mtb) infects one-third of the world’s population and causes nearly 1.3 million deaths per year. Limited information is available about the immune responses during Mtb infection in type 2 diabetic hosts. Our laboratory developed an experimentally induced type 2 diabetes (T2DM) model in wild-type C57BL/6 mice and found that IL-22 and type 3 innate lymphoid cells (ILC3s) reduce inflammation and mortality of Mtb-infected T2DM mice. Our laboratory also found that Mtb-infected alveolar macrophages (AMs) from T2DM mice undergo necroptosis compared to Mtb-infected AMs of non-T2DM mice. In the current study, we determined whether recombinant IL-22 treatment of γMtb-stimulated macrophages of T2DM mice inhibits the expression of necroptosis, reduces inflammatory cytokine production, and regulates the metabolism of the macrophages. We found that γMtb stimulation of T2DM mice lung macrophages significantly enhanced the expression of necroptotic markers such as pMLKL (phosphorylated pseudokinase mixed lineage kinase domain-like protein) compared to γMtb-stimulated lung macrophages of non-diabetic mice. Recombinant IL-22 treatment significantly inhibited the expression of pMLKL by γMtb stimulated lung macrophages of T2DM mice. The treatment marginally reduced the glycolytic parameters of these macrophages. However, the treatment had no effect on pro-inflammatory cytokines (IL-6 and TNF-α) production by γMtb-stimulated macrophages of T2DM mice. In future studies, live Mtb H37Rv will be used to infect macrophages to determine cell viability and necroptosis. Further understanding of the mechanisms involved in IL-22-mediated inhibition of pMLKL will help to develop therapies to prevent excess inflammation in T2DM individuals with active and latent tuberculosis infection

Epidemiology of eye diseases: outcomes from a free provincial eye clinic in Papua New Guinea

AimTo ascertain the prevalence and pattern of eye problems in Madang Province, Papua New Guinea.Materials and methodsA six-month retrospective study was performed at Madang Provincial Hospital Eye Clinic. Convenience sampling was used in this study and all patient records from January to June 2020 were included. Data was extracted using Microsoft Excel and the data included gender, age, occupation, district where the patient lived, presenting visual acuity, and diagnosis. It was then analyzed using International Business Machines Corporation’s Statistical Package for the Social Sciences version 26. A p-value of ≤0.05 was considered statistically significant.ResultsA total of 1,715 patients received services at the eye clinic between January and June 2020, and 1,664 were included in this study. The mean age of the patients was 39.3 ± 20.3 years. There were slightly more males (50.4%) than females. The overall leading ocular morbidities were corneal ulcers and keratitis (20.7%), refractive errors (17.4%), and cataracts (16.8%). More than half of the patients (56.2%) were either visually impaired or blind. Nearly half of the patients (41.8%) traveled long distances to seek services at the eye clinic. There was a significant association between demographic characteristics, diagnosis, and level of visual impairment.ConclusionThere is a high prevalence of potential causes of visual impairment and blindness in Madang Province and these conditions affect all age groups and genders. It is essential to increase accessibility to eye care services in the country

Clinical and sociodemographic characteristics of glaucoma patients at a tertiary referral facility in Zimbabwe

PurposeTo evaluate the clinical and socio-demographic profile of patients living with glaucoma and receiving care in a tertiary eye center in Zimbabwe.MethodA hospital-based retrospective study of clinical records of glaucoma patients from January 2014 to December 2018. The study involved collating demographic information of patients, visual acuities, (VA) intraocular pressure, (IOP), cup-to-disc ratios, (CDRs), average retinal nerve fibers thickness, (RNFL), cup volume, cup-to-disc area, vertical cup-to-disc ratio, (VCDR), rim area, disc area, glaucoma hemifield test, visual field indices and the management of glaucoma.ResultsNine thousand one hundred and eighty-five (9,185) folders were retrieved. Out of these, 432 (4.7%) qualified for the study and were analyzed. There were 267 (61.8%) males and 165 (38.2%) females. The mean age (± Standard deviation, SD) of the patients was 62.66 ± 15.94 years, (range 10 - 110 years). The means visual acuity (VA): OD =1.30 ± 1.06 Logarithm of the Minimum Angle of Resolution, (logMAR), OS = 1.33 ± 1.06 logMAR; IOP: OD = 29.51 ± 12.89 mmHg, OS: 29.17 ± 12.59 mmHg; CDRs: OD = 0.91 ± 0.14 D, OS = 0.92 ± 0.14 D; and the average RNFL thickness was 72.76 ± 18.26 µm and 71.24 ± 23.17 µm in the right and left eye respectively. The mainstay of treatment was medication only. ConclusionThere were more males than females receiving glaucoma care at the tertiary level. Glaucoma cases included juveniles but the mean age was mostly the elderly. It was characterized by high IOPs, large CDRs, and thin RNFL suggestive of late presentation

Patients’ Perspective on Barriers to Utilization of a Diabetic Retinopathy Screening Service

This study was conducted to determine the barriers to the utilization of diabetic retinopathy (DR) screening in Papua New Guinea (PNG). A list of patients booked for DR screening at Madang Provincial Hospital Eye Clinic (MPHEC) between January 2017 and December 2021 who had not been screened was retrieved, and the patients were invited to participate in the study. The data were collected using a structured questionnaire, and IBM Statistical Package for Social Sciences version 26 was used for the analysis. p p p p = 0.002). More than half of the respondents (63.5%) had discontinued using pharmacotherapy for DM. There is a high rate of nonadherence to diabetes (DM) and DR treatment in PNG. There is a need for public health campaigns about DM and strategic DR screening at the community level in PNG and similar countries

[In Press] Trends in myopia management attitudes and strategies in clinical practice : survey of eye care practitioners in Africa

Purpose: There remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world. Methods: A self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities. Results: Responses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options. Conclusions: African ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners’ perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa