Facilitated Peptide Transport via the Mucosal Epithelium

A hallmark of autoimmunity is the breakdown of tolerance and generation of effector responses against self-antigens. Re-establishment of tolerance in autoimmune disorders was always the most desired treatment option; however, despite many efforts, clinical trials have been largely unsuccessful. This also applies to the generation of oral tolerance, which seems to be a default response type of the mucosa-associated lymphoid tissues to harmless antigens. In this study, we report improved efficacy of oral tolerance induction by coupling antigen with the newly identified mucosal carrier peptide 13C. Antigen coupled to 13C is efficiently taken up in the gastrointestinal tract and could be visualized in cells of the lamina propria. Oral, rectal, or nasal treatment effectively induced the proliferation of antigen-specific T cells with some increase in the frequency of regulatory T cells. In a model of delayed-type hypersensitivity, especially intrarectal tolerization treatment resulted in reduced footpad swelling, demonstrating a moderate tolerogenic effect of mucosal treatment with 13C coupled antigen. Coupling of antigens to a transmucosal carrier, therefore, is a promising tool to improve the efficacy of vaccination via mucosal surfaces

Ergebnisbericht der „GeMSe“-Studie: Gesundheitskompetenz und Barrieren in der Gesundheitsversorgung von Mitgliedern der Selbsthilfe

Hintergrund Die gegenwärtige Corona-Pandemie stellt Mitglieder von Selbsthilfegruppen vor Herausforderungen und zeigt, dass die Gesundheitskompetenz immer wichtiger wird, denn die Gesundheitskompetenz bezieht sich auf das Finden, Verstehen, Beurteilen und Anwenden von Gesundheitsinformationen. Menschen mit Behinderungen gehören einer Bevölke-rungsgruppe an, die oftmals benachteiligt wird, auch hinsichtlich ihrer Gesundheit. Damit eine gleichberechtigte Gesundheitsversorgung gewährleistet werden kann, sollte ein Zugang zum Gesundheitswesen ohne Barrieren ermöglicht werden. Ziel der Studie „Gesund-heitskompetenz von Mitgliedern der Selbsthilfe (GeMSe)“ ist es, die individuelle Gesundheitskompetenz, das Suchverhalten nach Gesundheitsinformationen und wahrgenommene Barrieren im Gesundheitssystem abzubilden. Methode Die Datenbasis bildet eine Online-Befragung von 778 Mitgliedern von Selbsthilfegruppen, welche von Oktober 2019 bis Januar 2020 von der Technischen Universität Dortmund in Zusammenarbeit mit der Hochschule Fulda durchgeführt wurde. Die statistische Auswertung erfolgte mittels deskriptiver, uni- sowie bivariater Analysen durchgeführt mit SPSS Statistics (Version 25). Ergebnisse Ein Großteil der Befragten hat nach eigener Einschätzung Schwierigkeiten beim Finden, Verstehen, Beurteilen und Anwenden von gesundheitsspezifischen Informationen. Mitglieder der Selbsthilfe verwenden am häufigsten internetbasierten Quellen wie „Google“, um nach gesundheitsrelevanten Informationen zu recherchieren. Mehr als die Hälfte der Be-fragten gaben an, vor und/oder nach dem Besuch des/der Arztes/ Ärztin nach zusätzlichen Gesundheitsinformationen zu suchen. Bezüglich der Erfahrungen und Zufriedenheit mit der medizinischen Versorgung zeigen die Ergebnisse, dass mehr als die Hälfte der Befragten positive Erfahrungen im Gesundheitssystem, insbesondere mit der Zeitdauer im Arzt-Patienten-Gespräch gemacht haben. In Bezug auf die künftigen Entwicklungen im Gesundheitswesen gab über die Hälfte der Befragten an, Befürchtungen zur zukünftigen Entwicklung im Gesundheitswesen zu haben. Schlussfolgerung Der Zugang zur Gesundheitsversorgung und die angemessene Nutzung gesundheitsbezogener Informationen sind für Menschen mit einer chronischen Erkrankung oder Behinderung, die täglich gesundheitliche Entscheidungen treffen müssen, von großer Bedeutung. Daher ist es für die Selbsthilfe erforderlich, die Gesundheitskompetenz ihrer Mitglieder zu stärken und sie bei der Suche nach Gesundheitsinformationen zu unterstützen. Die Selbsthilfe sollte auf die Befürchtungen ihrer Mitglieder eingehen und reagieren. Auf dieser Grundlage ist es empfehlenswert, weitere Forschungen hinsichtlich der Gesundheitskompetenz bei Mitgliedern von Selbsthilfegruppen, dem Informationssuchverhalten und den Barrieren in der Gesundheitsversorgung durchzuführen

Situational determinants of cognitive, affective, and compassionate empathy in naturalistic digital interactions

Empathy is apparent in computer-mediated communication (CMC), yet little is known about the situational predictors of empathic responses when interacting digitally. We used a diary methodology to explore: (1) the degree three types of empathy (cognitive, affective, and compassionate) are experienced in students' everyday (text- and image-based) dyadic digital interactions; (2) which situational factors are important for (different types of) empathy in CMC; and (3) how empathy reported in everyday CMC affects participants' perceptions of their empathy in CMC and face-to-face (FtF) contexts. One hundred student volunteers (50 women, Mage = 22.57 years) completed a “digital interaction diary” for three consecutive days, yielding 1939 observations. Participants reported significantly more cognitive than affective empathy, and significantly greater affective than compassionate empathy. Several situational variables (e.g., number of communications, recipient) were related to empathy overall, while others (e.g., subject, mood) contributed to discrete contextual profiles for the empathy subtypes. Empathy reported in the diaries predicted a more favourable ratio of perceived CMC to FtF empathy, particularly for those lower in baseline trait empathy. These findings help elucidate the multidimensional experience of empathy in CMC interactions

A case study exploring employment factors affecting general practice nurse role development

Aim: The aim of this study was to explore the factors affecting role development in practice nursing in the United Kingdom.  Background: General practice is currently central to National Health Service reform, producing favourable conditions for the practice nurse role to be further strengthened and developed. However, the literature has continued to describe evidence that practice nurses are a disempowered, isolated group with many constraints reducing their ability to respond to opportunities to develop their role. The rationale for conducting the study was therefore to provide a greater understanding about the constraining factors and their influence on practice nurses wishing to develop their role.  Method: The method used to conduct the research followed a case approach, as the subject being investigated was complex with multiple inter-related factors and the approach was exploratory. The cases comprised six UK general practices and the participants within each case were a practice nurse, a GP and a practice manager.  Findings: A combination of factors was found to contribute to the way the practice nurse role evolves. These are education, practice culture, practice nurse personal characteristics and empowerment. Empowerment holds the key to maximising the conditions favourable to practice nurse role evolution. This is not, however, a 'single' factor; it represents the combined synergistic effects of practice culture and practice nurse personal characteristics on creating an empowering environment. The inter-relationship between these was captured in a framework and given the title 'empowering employment principles'.  ConclusionL The 'empowering employment principles' illustrate the features most conducive to role evolution, thus providing a tool for practice nurses and their employers to enhance opportunities for nurses to develop their role

Tolerogenic Modulation of the Immune Response by Oligoglycerol– and Polyglycerol–Peptide Conjugates

Peptide-based therapy is a promising strategy for antigen-specific immunosuppression to treat or even heal autoimmune diseases with significantly reduced adverse effects compared to conventional therapies. However, there has been no major success due to the drawbacks of native peptides, i.e., limited bioavailability. Considering the importance and limitations of peptide-based therapies for treatment of autoimmune diseases, we designed and constructed oligoglycerol (OG)- and polyglycerol (PG)-based peptide conjugates. They were evaluated for their biological activity (in vitro and in vivo), bioavailability, and tolerogenic potential. Among the OG- and PG-peptide constructs, PG-peptide constructs exhibited an extended bioavailability compared to OG-peptide constructs and unconjugated peptide. Interestingly, size, structure, and linker chemistry played a critical role for the tolerogenic capacity of the constructs. The PG-peptide construct bound via an ester linkage was the most tolerogenic conjugate, while the PG-peptide construct bound via an amide induced stronger proliferation, but also higher TNF production and lower frequencies of Foxp3⁺ regulatory T-cells. Therefore, we conclude that PG–peptide conjugates bound via an ester linkage are not only promising candidates for tolerogenic vaccination, but also open a new avenue toward the application of peptides for the treatment of autoimmune diseases