Increased expression of T-helper cell activation markers in peripheral blood of children with atopic asthma

Background: Activated T-helper (CD4) cells have been implicated to contribute to the pathogenesis of bronchial asthma. However, the profile of circulating CD4 subsets in relation to disease activity and asthma severity is unclear.Objective: To study the dynamic changes in peripheral blood CD4 cells expressing the activation markers naïve/memory (CD45RA/CD45RO) and interleukin–2 light chain receptor (CD25) in asthmatic children during and after resolution of acute asthma attacks and to determine whether the expression of these activation markers would be of value in monitoring asthma severity and the response to glucocorticoid inhalation.Methods: Peripheral blood samples were obtained from 20 asthmatic children aged between 0.5 and 9 years (mean±SD: 4.37±2.37 years) with acute asthma attacks, 10 children with lower respiratory tract infection and 20 healthy, age-matched subjects. CD4 cells expressing CD45RA, CD45RO, CD45RA+RO+ and CD25 were analyzed by dual flow cytometry and serum IgE was measured by ELISA. In asthmatic children, the measurements were repeated after the resolution of acute attacks.Results: During acute asthma attacks, the percentages of CD45RA, CD45RO, CD45RA+RO+ and CD25 were significantly increased as compared to the control group (p<0.05 for CD45RA and <0.0001 for the other 3 subsets). After resolution of asthma attacks, a significant reduction of all subsets was noticed and the percentages of CD45RA and CD45RO decreased to normal values while those of CD45RA+RO+ and CD25 remained significantly higher than the controls (p<0.05 for each marker). Unlike healthy children and patients with acute lower respiratory infections, asthmatic children showed increased CD45RO/CD45RA ratio (>1) and a significant increase of the percentage of CD45RA+RO+. During acute asthma attacks, patients with severe persistent asthma showed the highest percentages of all T- helper subsets when compared to those with moderate or mild persistent asthma. Positive correlations were found between serum IgE levels and both CD45RO and CD25 (r = 0.962, p<0.001 and 0.882, p<0.05 respectively) during acute asthma attacks and these correlations remained significant in remission (r = 0.632, p<0.05 and 0.589, p<0.05 respectively). Glucocorticoid inhalation therapy induced a significant reduction in the percentage of CD45RO, CD45RA+RO+ and CD25.Conclusion: Peripheral blood T-helper cell activation markers are reliable indicators for monitoring disease activity and severity of asthma. The reversed ratio of memory/ naïve T-helper cells together with the presence of a clone of cells co-expressing both naive and memory surface markers feature atopic asthma from acute lower respiratory infections. Glucocorticoid inhalation therapy induces a significant inhibition of peripheral blood T-helper cell activation markers.Key words: Children, atopic asthma, T-helper cell subsets, glucocorticoid inhalation, lower respiratory infections, CD45RO, CD45RA, CD25

The geoaccumulation index and enrichment factor of mercury in mangrove sediment of Port Klang, Selangor, Malaysia.

Mangrove areas are important to the ecosystem. One of its crucial functions is as a sink of pollutants, especially metal ions. However, the accumulation of metals in mangrove sediment can generate negative impacts on plant growth, microbial activity, and soil fertility. Apart from that, the severity of the impact is highly influenced by the type of metal found in the sediment and the quality of sediment itself. One of the metals that have adverse effects on the environment is mercury. The objectives of this study are to determine the concentration and distribution of mercury and to assess the enrichment of mercury in Port Klang mangrove sediment by using geoaccumulation index and enrichment factor. Sediment samples were collected from 30 sampling points that cover Langat River and Klang River estuaries, Lumut Straits, Pulau Klang, and Pulau Indah. During sampling, water parameters such as pH, salinity, electrical conductivity, and total dissolved solids were measured in situ, whereas the total mercury in sediment samples was determined at the laboratory using inductively coupled plasma mass spectrometry. In this study, mercury was found to be concentrated along Lumut Strait especially in the mixing zone near the confluence of Langat River and at the jetty to Pulau Ketam. The geoaccumulation index and enrichment factor (calculated using logarithmized data of the reference element) found that three stations were enriched with mercury. In addition, geoaccumulation index was also observed to be more objective compared to enrichment factor whose results were influenced by the concentration of reference element used

Pseudoneoplastic lesions of the testis and paratesticular structures

Pseudotumors or tumor-like proliferations (non-neoplastic masses) and benign mimickers (non-neoplastic cellular proliferations) are rare in the testis and paratesticular structures. Clinically, these lesions (cysts, ectopic tissues, and vascular, inflammatory, or hyperplastic lesions) are of great interest for the reason that, because of the topography, they may be relevant as differential diagnoses. The purpose of this paper is to present an overview of the pseudoneoplasic entities arising in the testis and paratesticular structures; emphasis is placed on how the practicing pathologist may distinguish benign mimickers and pseudotumors from true neoplasia. These lesions can be classified as macroscopic or microscopic mimickers of neoplasia

Impact of Safety-Related Dose Reductions or Discontinuations on Sustained Virologic Response in HCV-Infected Patients: Results from the GUARD-C Cohort.

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced ≥1 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with ≥1 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not ≥5. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin.This study was sponsored by F. Hoffmann-La Roche Ltd, Basel, Switzerland. Support for third-party writing assistance for this manuscript, furnished by Blair Jarvis MSc, ELS, of Health Interactions, was provided by F. Hoffmann-La Roche Ltd, Basel, Switzerland

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

Background: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. Methods: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. Results: SVR24 rates were 46.1 % (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1,2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. Conclusions: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginter-feron alfa-2a/ribavirin

Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019

Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38)

The IceCube Neutrino Observatory Part III: Cosmic Rays

Papers on cosmic rays submitted to the 33nd International Cosmic Ray Conference (Rio de Janeiro 2013) by the IceCube Collaboration