Apoptotic cell-based therapies against transplant rejection: role of recipient’s dendritic cells

One of the ultimate goals in transplantation is to develop novel therapeutic methods for induction of donor-specific tolerance to reduce the side effects caused by the generalized immunosuppression associated to the currently used pharmacologic regimens. Interaction or phagocytosis of cells in early apoptosis exerts potent anti-inflammatory and immunosuppressive effects on antigen (Ag)-presenting cells (APC) like dendritic cells (DC) and macrophages. This observation led to the idea that apoptotic cell-based therapies could be employed to deliver donor-Ag in combination with regulatory signals to recipient’s APC as therapeutic approach to restrain the anti-donor response. This review describes the multiple mechanisms by which apoptotic cells down-modulate the immuno-stimulatory and pro-inflammatory functions of DC and macrophages, and the role of the interaction between apoptotic cells and APC in self-tolerance and in apoptotic cell-based therapies to prevent/treat allograft rejection and graft-versus-host disease in murine experimental systems and in humans. It also explores the role that in vivo-generated apoptotic cells could have in the beneficial effects of extracorporeal photopheresis, donor-specific transfusion, and tolerogenic DC-based therapies in transplantation

Cytological screening for cervical cancer and associated factors in the penitentiary population of Peru

ABSTRACT Objective To determine the prevalence and factors associated with the screening of cervical cancer by Papanicolaou in the penitentiary population of Peru. Method A cross-sectional study was conducted using data from the 2016 National Penitentiary Population Census of Peru. The dependent variable was the cytological screening of cervical cancer during the last year. The independent variables were classified as facilitators, sociodemographic predisposers, and generators of need for the use of health services. The multivariate association was estimated through adjusted prevalence ratios (aPR) and 95% confidence intervals (95% CI), using Poisson regression and using the variables with p <0.05 in the bivariate. Results A total of 4515 women incarcerated in the 67 prisons of Peru entered the study. 69% (95% CI: 67.81-70.5) performed cytological screening during the last year and this is associated with having public health insurance (aPR 1.28 , 95% CI: 1.21-1.36), go to prison health services (aPR 1.18 , 95% CI: 1.12-1.24) and have a history of cancer (aPR 1.14, 95% CI: 1.02-1.26). Age, number of children, sports activities and the type of prison were also associated with cytological screening. Discussion There is an association between cytological screening and access to health services, sociodemographic predispositions and pathological backgrounds of women incarcerated in Peru. More research should be promoted on health prevention behaviors in this population