TLR5-Mediated Sensing of Gut Microbiota Is Necessary for Antibody Responses to Seasonal Influenza Vaccination

SummarySystems biological analysis of immunity to the trivalent inactivated influenza vaccine (TIV) in humans revealed a correlation between early expression of TLR5 and the magnitude of the antibody response. Vaccination of Trl5−/− mice resulted in reduced antibody titers and lower frequencies of plasma cells, demonstrating a role for TLR5 in immunity to TIV. This was due to a failure to sense host microbiota. Thus, antibody responses in germ-free or antibiotic-treated mice were impaired, but restored by oral reconstitution with a flagellated, but not aflagellated, strain of E. coli. TLR5-mediated sensing of flagellin promoted plasma cell differentiation directly and by stimulating lymph node macrophages to produce plasma cell growth factors. Finally, TLR5-mediated sensing of the microbiota also impacted antibody responses to the inactivated polio vaccine, but not to adjuvanted vaccines or the live-attenuated yellow fever vaccine. These results reveal an unappreciated role for gut microbiota in promoting immunity to vaccination

Pleuropulmonary hydatid disease treated with thoracoscopic instillation of hypertonic saline

Hydatid disease is caused by the larval stage of the cestode, Echinococcus granulo-sus. Man is the intermediate host in its life cycle. The most common organ involved is liver followed by lung. Although surgery remains the definitive treatment for symptomatic lesions, it is associated with considerable morbidity. Other less inva-sive treatment strategies as an adjunct to medical treatment that have been tried in various case series include percutaneous aspiration, instillation and re-aspiration of scolicidal agents (PAIR), and thoracoscopic removal of cysts located subpleurally. Here we report the case of a 58 year old gentleman with hepatic and pleuropulmo-nary hydatid disease who was subjected to medical thoracoscopy and instillation of hypertonic saline (3%), followed by medical management with albendazole with which complete resolution of the pulmonary cysts was achieved

PLEUROPULMONARY HYDATID DISEASE TREATED WITH THORACOSCOPIC INSTILLATION OF HYPERTONIC SALINE

Hydatid disease is caused by the larval stage of the cestode, Echinococcus granulosus. Man is the intermediate host in its life cycle. The most common organ involved is liver followed by lung. Although surgery remains the definitive treatment for symptomatic lesions, it is associated with considerable morbidity. Other less invasive treatment strategies as an adjunct to medical treatment that have been tried in various case series include percutaneous aspiration, instillation and reaspiration of scolicidal agents (PAIR), and thoracoscopic removal of cysts located subpleurally. Here we report the case of a 58 year old gentleman with hepatic and pleuropulmonary hydatid disease who was subjected to medical thoracoscopy and instillation of hypertonic saline (3%), followed by medical management with albendazole with which complete resolution of the pulmonary cysts was achieved