The social identity of Roman freedmen probing the religious evidence

Aceptando la estrecha relación entre status social y actos religiosos, el autor defiende, sin embargo, la inexistencia de cultos exclusivos de una determinada clase social, a excepción de los cultos estatales, debido a que el sistema religioso romano prestaba mayor atención a la distinción entre religión pública y privada que entre la gradación de las divinidades. Centrándose en la figura del liberto, el autor explica que se trataba de un grupo social que intentaba autoafirmarse como colectivo, separándose de los esclavos, a la vez que debían conquistar un lugar individual en la sociedad. Dos aspectos de la religiosidad de los libertos son discutidos: las asociaciones con la divinidad y los cultos que permiten la promoción social.__________________________The author believes the close relationship between social status and religious acts. He sujects, however, the lack of cults for a specific social class, except the oficial religion, because in the roman religious system distinction between public and private religiosity was more relevant than that between inferior and superior deities. He focuses on freedmen to explain that it was a social group that adopted in their ways of self-representation a double perspective, seeking to segregated themselves of slaves and the other on the community in which they had to conquer a proper. Two subjects are discussed: the relationship with the divine and the upwards cults

Clinical challenges of vestibular schwannoma

Vestibular schwannomas (VS), also named acoustic neurinoma, are benign tumors that originate from the Schwann cells of one of the four vestibular nerves (two at each side). These nerves are part of the eighth cranial nerve, the vestibulocochlear nerve, also known as the statoacoustic nerve. The vestibular nerves are located in the cerebellopontine angle, the space between brainstem, cerebellum and temporal bone. VS are the most common neoplasm located in the cerebellopontine angle and account for 8% of all intracranial tumors (1). The majority (95%) of VS are sporadic and occur unilateral. VS may exhibit a remarkable variable growth pattern: some tumors show a clear progression while others remain dormant and on occasion undergo shrinkage (2). The clinical symptoms most frequently seen are progressive (unilateral) hearing loss, vertigo, and tinnitus. Options for Treatment are observation (wait and scan), radiotherapy, or microsurgery. The choice of treatment depends on tumor size, severity and progression of the clinical symptoms, age of the patient, and patient preference.This thesis describes some of the clinical aspects of VS which are relevant for treatment. These concern the epidemiology, diagnostic challenges, clinical predictors affecting selection, and surgical technique and outcome.KNOKL bvLUMC / Geneeskund

Immune regulation in type 1 diabetes : towards a tissue specific cell therapy

Type 1 diabetes is a T-cell mediated autoimmune disease in which the insulin producing cells in the islets of Langerhans are destroyed. No cure exists yet, but multiple types of immune suppressive regimens are explored. In this thesis I studied the opportunities to dampen autoimmunity in type 1 diabetes, with the focus on the possibility of using tolerogenic dendritic cells loaded with islet antigens as cell therapy in patients with type 1 diabetes. Tolerogenic DCs appear suitable candidates to modulate T-cell response at different levels and are able to induce antigen specific regulatory T-cells, utilizing various mechanisms to suppress pro-inflammatory responses. Hence, the chance for successful control of autoimmunity in patients treated with tolerogenic DC therapy may be increased compared to monotherapy. Tolerogenic DCs as cell therapy have the potential to modulate the immune system. Although replacement or enhancement of insulin producing beta-cells is warranted, focusing on diminishing the causal pathology, the immune attack on the islets of Langerhans, could be a preferential option, as it is still difficult to challenge existing autoimmunity with the current arsenal of immunosuppressive drugs. This tissue-specific intervention cell therapy might offer new opportunities for the treatment of type 1 diabetes.UBL - phd migration 201

Development of type 1 diabetes in a patient treated with anti-TNF-α therapy for active rheumatoid arthritis

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Reestablishment of the smile after hypoglossal-facial nerve transfer: what can we learn

Objective The aim of this study was to assess the ability to smile following a hypoglossal-facial nerve transfer (N12-N7).Design This is a retrospective chart review.Setting National tertiary referral center for skull base pathology.Participants Seventeen patients.Main Outcome Measures The ability to smile following an N12-N7 transfer was assessed by five medical doctors on photographs of the whole face and frontal, orbital, and oral segments. The (segmented) photographs were scored for the symmetry, asymmetry, and correct or incorrect assessment of the affected side.Results Seventeen patients were analyzed by 5 assessors providing 85 assessments. The whole face at rest was judged symmetrical in 26% of the cases and mildly asymmetrical in 56%. Frontal, orbital, and oral segments were symmetrical in 63, 20, and 35%, respectively. The affected side was correctly identified in 76%. When smiling, the whole face was symmetrical in 6% and mildly asymmetric in 59%. The affected side was correctly identified in 94%. The frontal, orbital, and oral segments during smiling were symmetrical in 67, 15, and 6%, respectively. The affected side of the frontal, orbital, and buccal facial segments during smiling was correctly identified in 89, 89, and 96%, respectively. Interobserver variability with Fleiss' kappa analysis showed that the strength of the agreement during smile of the total face was good (0.771)Conclusions Following an N12-N7 transfer, a good facial symmetry at rest can be achieved. During smiling, almost all patients showed asymmetry of the face, which was predominantly determined by the orbital and oral segments. To improve the ability to smile after an N12-N7 transfer, additional procedures are needed.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Anti-TNF drives regulatory T cell expansion by paradoxically promoting membrane TNF-TNF-RII binding in rheumatoid arthritis

The interplay between inflammatory and regulatory pathways orchestrates an effective immune response that provides protection from pathogens while limiting injury to host tissue. Tumor necrosis factor (TNF) is a pivotal inflammatory cytokine, but there is conflicting evidence as to whether it boosts or inhibits regulatory T cells (T reg cells). In this study, we show that the therapeutic anti-TNF antibody adalimumab, but not the soluble TNF receptor etanercept, paradoxically promoted the interaction between monocytes and T reg cells isolated from patients with rheumatoid arthritis (RA). Adalimumab bound to monocyte membrane TNF from RA patients and unexpectedly enhanced its expression and its binding to TNF-RII expressed on T reg cells. As a consequence, adalimumab expanded functional Foxp3(+) T reg cells equipped to suppress Th17 cells through an IL-2/STAT5-dependent mechanism. Our data not only highlight the beneficial effect of membrane TNF on T reg cell numbers during chronic inflammation, but in addition reveal how a therapeutic antibody that is thought to act by simply blocking its target can enhance the regulatory properties of this proinflammatory cytokine

T cell receptor reversed polarity recognition of a self-antigen major histocompatibility complex

Central to adaptive immunity is the interaction between the αβ T cell receptor (TCR) and peptide presented by the major histocompatibility complex (MHC) molecule. Presumably reflecting TCR-MHC bias and T cell signaling constraints, the TCR universally adopts a canonical polarity atop the MHC. We report the structures of two TCRs, derived from human induced T regulatory (iTreg) cells, complexed to an MHC class II molecule presenting a proinsulin-derived peptide. The ternary complexes revealed a 180° polarity reversal compared to all other TCR-peptide-MHC complex structures. Namely, the iTreg TCR α-chain and β-chain are overlaid with the α-chain and β-chain of MHC class II, respectively. Nevertheless, this TCR interaction elicited a peptide-reactive, MHC-restricted T cell signal. Thus TCRs are not 'hardwired' to interact with MHC molecules in a stereotypic manner to elicit a T cell signal, a finding that fundamentally challenges our understanding of TCR recognition