What is the clinical relevance of different lung compartments?

The lung consists of at least seven compartments with relevance to immune reactions. Compartment 1 - the bronchoalveolar lavage (BAL), which represents the cells of the bronchoalveolar space: From a diagnostic point of view the bronchoalveolar space is the most important because it is easily accessible in laboratory animals, as well as in patients, using BAL. Although this technique has been used for several decades it is still unclear to what extent the BAL represents changes in other lung compartments. Compartment 2 - bronchus-associated lymphoid tissue (BALT): In the healthy, BALT can be found only in childhood. The role of BALT in the development of the mucosal immunity of the pulmonary surfaces has not yet been resolved. However, it might be an important tool for inhalative vaccination strategies. Compartment 3 - conducting airway mucosa: A third compartment is the bronchial epithelium and the submucosa, which both contain a distinct pool of leukocytes (e.g. intraepithelial lymphocytes, IEL). This again is also accessible via bronchoscopy. Compartment 4 - draining lymph nodes/Compartment 5 - lung parenchyma: Transbronchial biopsies are more difficult to perform but provide access to two additional compartments - lymph nodes with the draining lymphatics and lung parenchyma, which roughly means "interstitial" lung tissue. Compartment 6 - the intravascular leukocyte pool: The intravascular compartment lies between the systemic circulation and inflamed lung compartments. Compartment 7 - periarterial space: Finally, there is a unique, lung-specific space around the pulmonary arteries which contains blood and lymph capillaries. There are indications that this "periarterial space" may be involved in the pulmonary host defense

Expression of endothelia and lymphocyte adhesion molecules in bronchus-associated lymphoid tissue (BALT) in adult human lung

BACKGROUND: Bronchus-associated lymphoid tissue (BALT) is the secondary lymphoid tissue in bronchial mucosa and is involved in the development of bronchopulmonary immune responses. Although migration of lymphocytes from blood vessels into secondary lymphoid tissues is critical for the development of appropriate adaptive immunity, the endothelia and lymphocyte adhesion molecules that recruit specific subsets of lymphocytes into human BALT are not known. The aim of this study was to determine which adhesion molecules are expressed on lymphocytes and high endothelial venules (HEVs) in human BALT. METHODS: We immunostained frozen sections of BALT from lobectomy specimens from 17 patients with lung carcinoma with a panel of monoclonal antibodies to endothelia and lymphocyte adhesion molecules. RESULTS: Sections of BALT showed B cell follicles surrounded by T cells. Most BALT CD4+ T cells had a CD45RO+ memory phenotype. Almost all BALT B cells expressed alpha4 integrin and L-selectin. In contrast, 43% of BALT T cells expressed alpha4 integrin and 20% of BALT T cells expressed L-selectin. Almost all BALT lymphocytes expressed LFA-1. HEVs, which support the migration of lymphocytes from the bloodstream into secondary lymphoid tissues, were prominent in BALT. All HEVs expressed peripheral node addressin, most HEVs expressed vascular cell adhesion molecule-1, and no HEVs expressed mucosal addressin cell adhesion molecule-1. CONCLUSION: Human BALT expresses endothelia and lymphocyte adhesion molecules that may be important in recruiting naive and memory/effector lymphocytes to BALT during protective and pathologic bronchopulmonary immune responses

Examination of the role of Mycoplasma bovis in bovine pneumonia and a mathematical model for its evaluation

The authors screened 34 large cattle herds for the presence of Mycoplasma bovis infection by examining slaughtered cattle for macroscopic lung lesions, by culturing M. bovis from lung lesions and at the same time by testing sera for the presence of antibodies against M. bovis. Among the 595 cattle examined, 33.9% had pneumonic lesions, mycoplasmas were isolated from 59.9% of pneumonic lung samples, and 10.9% of sera from those animals contained antibodies to M.bovis. In 25.2% of the cases M. bovis was isolated from lungs with no macroscopic lesions. The proportion of seropositive herds was 64.7%. The average seropositivity rate of individuals was 11.3% but in certain herds it exceeded 50%. A probability model was developed for examining the relationship among the occurrence of pneumonia, the isolation of M. bovis from the lungs and the presence of M. bovis specific antibodies in sera

Phenotypic alterations in type II alveolar epithelial cells in CD4+ T cell mediated lung inflammation

<p>Abstract</p> <p>Background</p> <p>Although the contribution of alveolar type II epithelial cell (AEC II) activities in various aspects of respiratory immune regulation has become increasingly appreciated, our understanding of the contribution of AEC II transcriptosome in immunopathologic lung injury remains poorly understood. We have previously established a mouse model for chronic T cell-mediated pulmonary inflammation in which influenza hemagglutinin (HA) is expressed as a transgene in AEC II, in mice expressing a transgenic T cell receptor specific for a class II-restricted epitope of HA. Pulmonary inflammation in these mice occurs as a result of CD4⁺T cell recognition of alveolar antigen. This model was utilized to assess the profile of inflammatory mediators expressed by alveolar epithelial target cells triggered by antigen-specific recognition in CD4⁺T cell-mediated lung inflammation.</p> <p>Methods</p> <p>We established a method that allows the flow cytometric negative selection and isolation of primary AEC II of high viability and purity. Genome wide transcriptional profiling was performed on mRNA isolated from AEC II isolated from healthy mice and from mice with acute and chronic CD4⁺T cell-mediated pulmonary inflammation.</p> <p>Results</p> <p>T cell-mediated inflammation was associated with expression of a broad array of cytokine and chemokine genes by AEC II cell, indicating a potential contribution of epithelial-derived chemoattractants to the inflammatory cell parenchymal infiltration. Morphologically, there was an increase in the size of activated epithelial cells, and on the molecular level, comparative transcriptome analyses of AEC II from inflamed versus normal lungs provide a detailed characterization of the specific inflammatory genes expressed in AEC II induced in the context of CD4⁺T cell-mediated pneumonitis.</p> <p>Conclusion</p> <p>An important contribution of AEC II gene expression to the orchestration and regulation of interstitial pneumonitis is suggested by the panoply of inflammatory genes expressed by this cell population, and this may provide insight into the molecular pathogenesis of pulmonary inflammatory states. CD4⁺T cell recognition of antigen presented by AEC II cells appears to be a potent trigger for activation of the alveolar cell inflammatory transcriptosome.</p

Relationship of creative projects in anatomy to medical student professionalism, test performance and stress: an exploratory study

<p>Abstract</p> <p>Background</p> <p>The anatomy course offers important opportunities to develop professionalism at an early stage in medical education. It is an academically significant course that also engenders stress in some students.</p> <p>Methods</p> <p>Over a three-year period, 115 of 297 students completed creative projects. Thirty-four project completers and 47 non-completers consented to participate in the study. Projects were analyzed for professionalism themes using grounded theory. A subset of project completers and non-completers were interviewed to determine their views about the stress of anatomy and medical school, as well as the value of the creative projects. We also compared test performance of project completers and non-completers.</p> <p>Results</p> <p>Projects completed early in the course often expressed ambivalence about anatomy, whereas later projects showed more gratitude and sense of awe. Project completers tended to report greater stress than noncompleters, but stated that doing projects reduced stress and caused them to develop a richer appreciation for anatomy and medicine. Project completers performed significantly lower than non-completers on the first written exam (pre-project). Differences between groups on individual exams after both the first and second creative project were nonsignificant.</p> <p>Conclusion</p> <p>For some students, creative projects may offer a useful way of reflecting on various aspects of professionalism while helping them to manage stress.</p

Structural and Topographic Dynamics of Pulmonary Histopathology and Local Cytokine Profiles in Paracoccidioides brasiliensis Conidia-Infected Mice

Paracoccidioidomycosis (PCM), an endemic fungal infection of pulmonary origin resulting in severe disseminated disease, occurs in rural areas of most South American countries and presents several clinical forms. The infection is acquired by inhalation of specific fungal propagules, called conidia. Considering the difficulties encountered when studying the infection in humans, this work was done in mice infected by inhalation of infective fungal conidia thus mimicking the human natural infection. The lungs of mice were sequentially studied by histopathological and multiplex cytokine methods from 2 h to 16 weeks after infection to verify the course of the disease. The mycosis presented different morphologic aspects during the course of time, affecting several pulmonary compartments. Otherwise and based on the analysis of 30 cytokines, the immune response also showed heterogeneous responses, which were up or down regulated depending on the time of infection. By recognizing the different stages that correspond to the evolution of pulmonary lesions, the severity (benign, chronic or fibrotic) of the disease could be predicted and the probable prognosis of the illness be inferred

(How) do medical students regulate their emotions?

BACKGROUND: Medical training can be a challenging and emotionally intense period for medical students. However the emotions experienced by medical students in the face of challenging situations and the emotion regulation strategies they use remains relatively unexplored. The aim of the present study was to explore the emotions elicited by memorable incidents reported by medical students and the associated emotion regulation strategies. METHODS: Peer interviewing was used to collect medical students’ memorable incidents. Medical students at both preclinical and clinical stage of medical school were eligible to participate. In total 104 medical students provided memorable incidents. Only 54 narratives included references to emotions and emotion regulation and thus were further analyzed. RESULTS: The narratives of 47 clinical and 7 preclinical students were further analyzed for their references to emotions and emotion regulation strategies. Forty seven out of 54 incidents described a negative incident associated with negative emotions. The most frequently mentioned emotion was shock and surprise followed by feelings of embarrassment, sadness, anger and tension or anxiety. The most frequent reaction was inaction often associated with emotion regulation strategies such as distraction, focusing on a task, suppression of emotions and reappraisal. When students witnessed mistreatment or disrespect exhibited towards patients, the regulation strategy used involved focusing and comforting the patient. CONCLUSIONS: The present study sheds light on the strategies medical students use to deal with intense negative emotions. The vast majority reported inaction in the face of a challenging situation and the use of more subtle strategies to deal with the emotional impact of the incident. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-016-0832-9) contains supplementary material, which is available to authorized users

Editorial: Experimental models of asthma

Since 2002, a workshop entitled "Asthma in animal models" has been held once a year in Hannover, Germany. It is organized by the Fraunhofer Institute of Toxicology and Experimental Medicine in collaboration with the collaborative research centre "Sonderforschungsbereich" 587, "Immune reactions of the lung in infection and allergy" (Hannover Medical School). The aim of these meetings is an intense scientific exchange between researchers and clinicians coming from academic or industrial background. Over the years the topics within the extensive field of asthma and COPD have ranged from methodological aspects to the influence of infections and environmental factors up to perspectives in the development of new therapeutic strategies

Tertulias matemáticas dialógicas para el aprendizaje de las matemáticas en mujeres adultas no escolarizadas y sin titulación académica

[spa] Esta investigación se enmarca en el Objetivo 4 de la agenda internacional para el Desarrollo Sostenible 2030: Garantizar una educación inclusiva, equitativa y de calidad y promover oportunidades de aprendizaje durante toda la vida para todos (ONU, 2020). Las metas y esfuerzos globales que subyacen a este objetivo otorgan especial atención a la inclusión educativa de las mujeres ya que son ellas quienes continúan afrontando mayores barreras de participación y desarrollo derivadas de las múltiples condiciones de desigualdades que persisten. Ante este panorama, la comunidad científica internacional ha identificado Actuación Educativa de Éxito (AEE) (Flecha, 2015) que contribuyen a la inclusión social desde la educación. Una de estas AEE son las Tertulias Matemáticas Dialógicas (TMD) (Díez-Palomar, 2017) que consisten en la construcción colectiva de significados en torno a la lectura dialógica de una obra clásica en el campo de las matemáticas. Esta investigación se enfoca en la forma en cómo las TMD contribuyen en la inclusión educativa y empoderamiento para el uso crítico de las matemáticas de las mujeres adultas que no están escolarizadas y que no cuentan con titulación académica. Siguiendo el enfoque de la Metodología Comunicativa de investigación, se desarrollaron técnicas de recogida de información de corte cualitativo para el estudio de dos casos: uno en la Ciudad de México y otro en Barcelona. En ambas TMD participaban mujeres de distintas edades y procedentes de contextos diversos. Los hallazgos dan cuenta del impacto positivo de las TMD en dos dimensiones del aprendizaje de las matemáticas: actitudinal e instrumental. El funcionamiento de las TMD basado en el aprendizaje dialógico y la participación igualitaria de las mujeres, incidió en la superación de actitudes y concepciones negativas en torno a las matemáticas. Las interacciones establecidas en las TMD permitieron que las participantes transformaran el auto concepto de sí mismas sobre el aprendizaje, resignificaran el valor de las matemáticas en sus vidas y se empoderaran en el uso crítico de esta ciencia en su vida cotidiana. Así mismo, se manifestaron mejoras en competencias matemáticas de interpretación, formulación, uso de lenguaje matemático, representación y visualización matemática y reflexión y acción crítica en la resolución de problemas. Finalmente, la investigación también logra constatar un efecto en la motivación de las participantes por reincorporarse a la vida académica y promover el aprendizaje de las matemáticas en sus entonos inmediatos. Estos hallazgos pretenden motivar investigaciones más amplias e impulsar el interés científicos sobre las actuaciones educativas de enfoque comunitario que permiten la inclusión de las mujeres adultas que, por razones diversas, se encuentran excluidas de la educación y sin oportunidades valiosas de aprendizaje a lo largo de sus vidas.[eng] This research is framed on Objective 4 of the international agenda for Sustainable Development 2030: Guarantee inclusive, equitable and quality education and promote lifelong learning opportunities for all (UN, 2020). The global goals and efforts that underlie this objective pay special attention to the educational inclusion of women since they still face greater barriers to participation and development derived from the multiple and persistent inequalities. The international scientific community has identified Successful Educational Action (SEA´s) (Flecha, 2015) that contribute to social inclusion from education. One of these is Dialogic Mathematics Gatherings (DMG) (Díez-Palomar, 2017) that consist of collective meaning constructions around the dialogical reading of a classic work in the field of mathematics. This research focuses on how DMGs contribute to the educational inclusion and empowerment for critical use of mathematics by non-academic women. Following the Communicative Research Methodology approach, qualitative information collection techniques were developed for the study of two cases: one in Mexico City and the other in Barcelona. In both cases women from different ages and contexts were involved. Findings account for the positive impact of DMG on two mathematics learning dimensions: attitudes and skills. The functioning of the DMG based on dialogic learning and equal participation of women, influenced the overcoming of negative attitudes and misconceptions about mathematics. The interactions established allowed the participants to transform their self-concept of learning and create a new meaning about the value of mathematics in their lives. Likewise, improvements were manifested in mathematical skills and competencies as wells as: interpretation, formulation, use of mathematical language, representation and mathematical visualization, and reflection and critical action in solving problems. Finally, the research also shows an effect on the motivation of the participants to rejoin the academic life and promote the learning of mathematics in their context. These findings are intended to motivate broader research and boost scientific interest in community-based educational actions that allow the inclusion of adult women who are excluded from education and without valuable learning opportunities throughout their lives