Interleukin-8, Interleukin-1β, and Interferon-γ Levels Are Linked to PRRS Virus Clearance

Infection with porcine reproductive and respiratory syndrome virus (PRRSV) results in a weak antiviral immune response that leads to a persistent infection in a subset of pigs. We investigated the intensity and timing of the early cytokine responses to PRRSV infection to determine their utility as a predictor of persistence. As part of the “Big Pig” project, we evaluated cytokine gene expression in lymphoid tissues collected from pigs for up 202 days post-infection (dpi); serum samples were collected biweekly. Cytokine mRNA levels were compared between pigs that cleared the viral infection from serum and tissues (non-persistent [NP] pigs) to those of persistent (P) pigs, that had viral RNA in their serum for up to 126 dpi. The gene expression studies in the tracheobronchial lymph nodes (TBLN) of all the pigs showed upregulation of interferon-γ (IFN-γ)-associated T-helper 1 (Th-1) markers from 14–84 dpi, and of T-regulatory interleukin-10 (IL-10), but no upregulation of innate markers (IFN-A, IL-1B, and IL-8). At later time points (\u3e112 dpi) these genes were no longer differentially expressed and thus were uninformative for persistence studies. Statistical analyses of serum cytokine levels indicated that innate cytokine (IL-1β and IL-8) levels were upregulated early after infection. Interestingly, serum IL-8 levels in NP pigs were significantly higher than in P pigs at 14 dpi. When analyzed together, variations in all three of the serum cytokines tested (IL-8, IL-1β, and IFN-γ) was significantly correlated with virus level, accounting for ∼84% of the variations observed. These results indicate that while each cytokine individually has minor effects on the length of virus replication, the combination of cytokine activities should be considered when understanding the role of immunity in persistence

Emergency Nurses’ Perceptions of Opioid Use Disorder and Its Treatment in the Emergency Department

Objectives: To describe the knowledge and attitudes of emergency nurses regarding caring for patients with opioid use disorder in the emergency department.Background: Many eligible patients with opioid use disorder do not receive available emergency department services for treatment and harm mitigation. While prior study examined contributing provider factors, little is known of nursing factors. This study describes knowledge and attitudes of emergency nurses regarding patients with opioid use disorder and their evidence-based treatment services in the emergency department setting.Methods: Anonymous email surveys with novel and previously validated questions based on The Theory of Planned Behavior Framework were distributed to emergency department nurses at a large, urban tertiary-care hospital. Chi-Square and independent samples t-tests were used in analyses.Results: More than one third of nurses completed the questionnaire (39%, 85/218). Most showed willingness and confidence screening for substance use disorder (95% and 88% respectively). Higher confidence providing buprenorphine and take-home naloxone was significantly associated with having worked fewer years (8.33 v. 15.62 , p=0.01 and 7.38 v. 12.03, p=0.03 respectively). Confidence administering buprenorphine was significantly associated with receiving in-service training (p=0.03). Staff with knowledge of take-home naloxone, positive attitudes toward syringe service programs, and a belief in a biopsychosocial basis of addiction were significantly younger and had worked significantly fewer years than those not indicating these beliefs. Specific educational gaps were identified.Conclusion: Emergency nurses display willingness to champion evidence-based care for patients with opioid use disorder. Younger age and having worked fewer years were significantly associated with positive attitudes towards recovery science, harm mitigation, and services knowledge. Having worked fewer years was significantly associated with greater confidence performing treatment and harm mitigation. In-service training was significantly associated with greater confidence administering buprenorphine. Further study should support generalizability and determine which staff development measures generate improved outcomes

Interleukin-8, Interleukin-1β, and Interferon-γ Levels Are Linked to PRRS Virus Clearance

Infection with porcine reproductive and respiratory syndrome virus (PRRSV) results in a weak antiviral immune response that leads to a persistent infection in a subset of pigs. We investigated the intensity and timing of the early cytokine responses to PRRSV infection to determine their utility as a predictor of persistence. As part of the “Big Pig” project, we evaluated cytokine gene expression in lymphoid tissues collected from pigs for up 202 days post-infection (dpi); serum samples were collected biweekly. Cytokine mRNA levels were compared between pigs that cleared the viral infection from serum and tissues (non-persistent [NP] pigs) to those of persistent (P) pigs, that had viral RNA in their serum for up to 126 dpi. The gene expression studies in the tracheobronchial lymph nodes (TBLN) of all the pigs showed upregulation of interferon-γ (IFN-γ)-associated T-helper 1 (Th-1) markers from 14–84 dpi, and of T-regulatory interleukin-10 (IL-10), but no upregulation of innate markers (IFN-A, IL-1B, and IL-8). At later time points (>112 dpi) these genes were no longer differentially expressed and thus were uninformative for persistence studies. Statistical analyses of serum cytokine levels indicated that innate cytokine (IL-1β and IL-8) levels were upregulated early after infection. Interestingly, serum IL-8 levels in NP pigs were significantly higher than in P pigs at 14 dpi. When analyzed together, variations in all three of the serum cytokines tested (IL-8, IL-1β, and IFN-γ) was significantly correlated with virus level, accounting for ∼84% of the variations observed. These results indicate that while each cytokine individually has minor effects on the length of virus replication, the combination of cytokine activities should be considered when understanding the role of immunity in persistence.This article is from Viral Immunology 23 (2010): 127, doi:10.1089/vim.2009.0087.</p