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Kindle Money Mastery

If you have ever wanted to be able to be an author for a living or as a side hobby, this is the online course for you! This course gives you access to all kinds of ebook and materials on how to make the most of the Amazon Kindle Store to make a huge amount of money! You don't need to be a creative genius, spend Hours on end writing, or even know how to use Kindle! All that you have to do is follow the instructions in this course by Stefan Pylarinos. Stefan built this course based on what he does for a living Every Single DAY. This is REAL information that has been perfected in a real business Why would this NOT work for you? This is how Stefan makes his money Why not you? Just think You can make living money writing Kindle books. And you can learn all about how to get started making money with K Money Mastery! Read more here...

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M0 That Fail To Switch From A Proangiogenic To An Angioinhibitory Phenotype Contribute To Pathological Angiogenesis

Tigations have shown that both resting and activated M0 produce TSP1. DiPietro et al. (68) has reported an approximately sixfold increase in the steady-state levels of TSP1 mRNA expression in the murine monocyte line WEHI-3 when the cells were treated for 24 h with the potent activating agent lipopolysaccharide (LPS), with peak secretion of TSP1 protein occurring by 8 h. An examination of TSP1 knockout mice clearly demonstrated that a deficiency in TSP1 can have a subtle yet detectable effect on a physiological function, such as wound neovascularization. Also, the introduction of pure TSP1 or TSP1-expressing M0 from wild-type mice partially corrects the defect in neovascularization (Nor et al., unpublished).

Correlates with Their Suppressive Capacity in Certain Models

The migratory phenotype of Treg subsets is discussed more controversially in the human system. Iellem et al. have observed an enrichment in E-selectin-binding and CCR4+ cells among CD25+CD4+ Tregs accompanied by a paucity of gut-homing (a4 7+, CCR9+) cells, suggesting that these cells most likely would home into the skin as well as inflamed sites (Iellem et al. 2003). This report contrasts with a recent finding from Jonuleit and colleagues who have shown that 15 -30 of human CD25+CD4+ Tregs expressed the integrin a4fi7, suggesting that these cells would preferentially migrate into the mucosa (Stassen 2004). However, in the murine system we did not observe a preferential migration of any of the analyzed Treg subsets into both noninflamed and inflamed mucosal tissues, although all subsets expressed the integrin a4 7 at reasonable frequencies (30 ) (Huehn et al. 2004 and unpublished observations). These findings indicate that Tregs similar to conventional effector memory T cells display...

E SHAPHyaluronan Complex in Cell Adhesion

To evaluate the effect of SHAP on the CD44-hyaluronan interaction in a simpler system, we compared the cell adhesion activity of the SHAP-hyaluronan complex purified from pathological synovial fluid with that of free hyaluronan. The CD44-positive cutaneous T cell lymphoma cell line Hut78, known to bind strongly to hyaluronan, was used for the adhesion assay. The SHAP-hyaluronan complex or free hyaluronan was immobilized on dishes pre-coated with HABP. The cells were then added, and incubated at room temperature for 30 min. To observe significant cell adhesion, the concentration of immobilizing hyaluronan concentration had to be higher than 0.5 mg mL however, significant adhesion was still observed even when the concentration of the SHAP-hyaluronan complex was reduced to 0.02 mg mL (our unpublished results). The results showed clearly that the presence of SHAP enhanced the cell adhesion. Although control experiments are necessary, the results are in line with the observation made by De...

Physiological Significance of Human Collagenase3

In addition to this putative role of collagenase-3 in human fetal bone development, a number of studies have examined the participation of this enzyme in other tissue remodeling processes. Nevertheless, care must be taken in extrapolating results obtained in rodents to the situation present in humans, especially in light of data suggesting that murine colla-genase-3 may also have to function as a murine collagenase-1, whose existence has yet to be demonstrated. One of the studies looking for potential collagenase-3 functions in murine tissues concluded that it may be involved in the ovarian function during the reproductive cycle.62 In fact, in Northern blot analysis of rat tissues, Balbin et al62 have demonstrated that collagenase-3 is expressed at high levels in the ovary and thus has a potential role in ovulation. The dynamics of collagenase-3 expression in rat ovary, with increasing levels at proestrus and estrus as the time of ovulation approaches and declining thereafter, is...

Pathological Significance of Human Collagenase3

Quently, collagenase-3 should be included among the molecular factors detected during the stromal reaction to invasive breast cancer, whose concerted action may be essential for tumor growth and progression.5 At present, this theory is without direct evidence, although preliminary clinical studies of collagenase-3 expression in these tumors suggest that production of high levels of this enzyme by breast carcinomas is a factor in poor prognosis in breast cancer patients (F. Vizoso, unpublished observations). Further support was provided by Lochter et al76 who have recently provided evidence that collagen invasion by TCL1 mouse mammary carcinoma cells producing collagenase-3 is reduced by half in the presence of collagenase-3 antisense oligonucleotides, but in contrast, invasion of SCg6 cells not expressing collagenase-3 remain unaffected. Treatments that increase collagenase-3 expression such as culture of TCL1 cells in the presence of Matrigel promote collagen invasion, whereas...

Immunologic Effects of Exosomes

Severity of established arthritis (18). In fact, exosomes were as effective as the parental DC. Moreover, exosomes from DC transduced with recombinant adenovirus encoding FasL (19) or IL-4 (unpublished data) produce exosomes able to suppress inflammation in a murine model of delayed type hypersensitivity and partially reverse established CIA. Because exosomes are more stable in vitro than DC, they may be a better approach for future treatment of arthritis and other autoimmune disorders.

Effect of HA1077 on Cerebral Infarction

HA1077 had been shown to inhibit migration of white blood cells to the ischemic brain in rats (Satoh et al. 1999a,b). In addition, in in vitro system, HA1077 inhibits production of free radicals by NADPH oxidase in WBC through the inhibition of PKC (Arai et al. 1993). Decrease of free radical production by inhibition of PKC seems to be an important part of the effectiveness of HA1077. As HA1077 inhibits the phosphorylation of calponin in the intact artery, the effects of HA1077 on both cerebral vasospasm and infarction can be attributed to both vasodilatation and anti-inflammation. In a recent clinical study, a double-blind trial of HA1077 in patients with acute cerebral infarction due to thrombosis showed that HA1077 significantly decreased motor weakness and improved ADL (unpublished data). Effectiveness of HA1077 has experimentally been suggested in many other diseases where Rho kinase is believed to be involved, including angina pectoris (Katsumata et al. 1997), bronchial asthma...

JCV in Progressive Multifocal Leukoencephalopathy PML is a de

If the human polyomaviruses are lymphotropic agents and lymphocytes are sites of persistent infection, then JCV DNA should regularly be present in the blood cells of the normal immunocompetent individual. This was supported by the detection of episomal JCV DNA in PBMC from healthy laboratory staff at a rate of 30 by Southern blot analyses. PCR demonstrated JCV DNA at a rate of more than 80 in the same group, although the concentration of JCV DNA varied from case to case. Serologic evaluation of the patients revealed high antibody titers, pointing to a pronounced humoral immune response and a persistent rather than a latent virus infection (unpublished findings Dorries et al., 1994). Based on all study results, the prevalence of virus-specific DNA ranged from 0 to 59 . This included blood donors with 39 (Azzi et al.,

D SHAPHyaluronan Complex and Inflammatory Bowel Disease

Disease characterized by discrete acute and chronic lesions, plaques, but the mechanism of both the inflammatory demyelinating and the neurodegenerative components of its pathogenesis are largely unknown. Because the disease progression is accompanied by a complex alteration of the extracellular matrix as a consequence of the breakdown of the blood-brain barrier, release and activation of extracellular proteases and synthesis of extracellular matrix, the relation between the dynamic alteration of the extracellular matrix and the pathogenesis is attracting more and more attention (78). Normal brain tissue as well as nearly acellular old MS plaques are negative for SHAP immunoreactivity, but relatively fresh plaques at the active phase of inflammation are positive for the SHAP-hyaluronan complex, implying a role for the complex in the pathogenesis of MS (our unpublished observations). As observed in the diseases mentioned above, CD44 is critical to the secondary leukocyte recruitment in...

IL10 Promoter Polymorphisms and Automimmune Disease

(-2763AA 0.37 in affecteds vs 0.36 in controls Gibson and Huizinga, unpublished results). Others have failed to find a similar association in an Italian SLE group.41 In summary, associations between IL-10 promoter polymorphisms, IL-10 production and autoimmune diseases have been documented. However, while association studies have yielded inconsistent results, the total number of affecteds from each of the various ethnic groups studied has not been large. Additionally, adequate numbers of studies have not been done in all ethnic groups. Recent resequencing efforts have uncovered a more complex promoter structure, and additional SNPs are being discovered in the promoter and in the 3'UTR41,75 (and Gibson, unpublished results). This raises the possibility that other, more complex SNP associations with disease phenotypes might be uncovered in future studies.

Cannabinoid targets for pain therapeutics

Perhaps because they possess either modest (ajulemic acid) or virtually no (HU-320) affinity for either CB1 receptors or CB2 receptors. While ajulemic acid produces its effects via CB1 receptors (unpublished findings from the authors' laboratory), HU-320 produces its effects by an unknown mechanism that is unlikely to be the CB . At sufficient doses, CT-3 produces catalepsy 92 similar to that observed with A9-THC. However, extensive dose studies would be required to determine whether there is a greater dose separation between its anti-nociceptive anti-inflammatory effects and its psychomotor side effects than that observed with typical cannabinoids. In a recent clinical trial of patients suffering from neuropathic pain, ajulemic acid possessed some efficacy 93 . While many questions about these and similar compounds are awaiting further research, this appears to be an important line of inquiry.

Cell Surface Expression of Stress Proteins

Sources (W.N.J., et al., unpublished observations). B-cell lines, T cells with y8 receptors, and mitogen-activated peripheral T cells were shown to react with anti-hsp 60 in indirect immunofluorescence and complement-dependent micro-cytotoxicity assays. Mitogen-activated T cells, but not resting T cells or other cell types, also reacted with anti-hsp 90. Surface expression of proteins related to hsp 110 or members of the hsp 70 family of stress proteins on T cells, B cells, and several monomyelocytic cell lines was not observed. In contrast to our preliminary data suggesting that the monomyelocytic line HL60 expressed hsp 90 after heat shock or stimulation with phorbol esters (14), positive anti-hsp 90 staining of this cell line and several other phagocytic cell lines was not demonstrable when cell death was limited to 5 or less.

Responses Of yS T Cells To 60 AND 70Kda Heat Shock Protein

Of autologous cells, which can be induced by trauma, malignancy, or infection (28). Providing experimental proof of this attractive idea has been difficult, although a recent study has shown that epidermal y5 T cells can respond to culture- or arsonate-stressed keratinocytes (29). In a different experimental system, however, it became evident much sooner that y8 T cells can respond to stress associated proteins. Testing randomly generated collections of y5 T-cell hybridomas derived from cells of newborn mouse thymus, adult mouse spleen, and various other tissues, we found that the majority of Vyl+ cells could be stimulated to cytokine secretion in the presence of recombinant mycobacterial heat shock protein 60 (hsp 60) or synthetic peptides derived from this stress protein (19,30-33). The response is specific, and its dependence on the TCR has been confirmed by TCR gene transfection. y8 T cells exhibiting polyclonal reactivity with hsp 60 are present in major lymphoid and many...

Standards of Care and Liability

Pharmacogenetic information may be an important consideration in the licensing of new medicines. Its management and disclosure during drug development and approval raises a number of important issues. For example, ADR data on one drug in a particular class may be highly relevant to the approval of another compound in the same class or active against the same target. However, it is generally not in the commercial interests of drug companies to disclose detailed findings from many of their unpublished clinical trials. This raises important questions about how to enable interfirm data sharing where it is in the public

Regulatory Effects Of Heat Shock Protein 60 On Innate Immune Cells

As mentioned before, it is now evident that HSP are released into the extracellular compartment in response of cells to stressful situations, e.g. during inflammation. Hsp60 has been found to be present in the circulation of normal individuals (Pockley et al., 1999 Xu et al., 2000), and increased serum levels have been observed in a number of pathological conditions like hypertension (Pockley et al., 2000 Pockley et al., 2002), arteriosclerosis (Wick et al., 2004 Xu et al., 2000) and renal vascular diseases (Wright et al., 2000). Emerging evidence coming from several studies suggest that extracellular HSP function as intercellular signalling proteins, which serve as danger signals to the innate immune system, thereby mediating and modulating a number of inflammatory reactions (Chen et al., 1999 Wallin et al., 2002). We and others have shown that human Hsp60 stimulates pro-inflammatory reactivity in innate immune cells, such as macrophages, dendritic cells (DC) and endothelial cells...

Chronic Pain outside the Surgical Context

The biopsychosocial model of chronic pain holds that other people in the patient's life make a material contribution to his or her pain experience. Solicitous responding by others, far from helping with pain actually makes pain and pain related disability worse 23, 53 . The operant conditioning model 90, 91 predicts that in offering pain contingent help (e.g. taking over household jobs) in response to expressions (grimacing) and behaviours (guarding) indicative of pain, well-intentioned spouses unwittingly positively reinforce the patient's pain behaviours leading to an increase in their frequency. On the other hand, the lack of any other person at all to provide love and care in a person's life is a risk factor for chronic pain (S. Rashiq, unpublished data). Other known, independent associations with chronic pain are physical inactivity, cigarette smoking, failing to graduate from high school, low income, being overweight and most chronic medical conditions (such as diabetes and...

Parp As Transcriptional Regulator Of Inflammation And Lymphocyte Homing

PARP may interfere with the sequence of events at several points. PARP has been shown to enhance activator-dependent transcription.60 Moreover, PARP has also been found to act as a coactivator for AP-2-mediated transcriptional activation.61 As synthesis of cytokines and chemokines occurs via activator-dependent transcription of cytokine genes,196-198 the possibility exists that PARP enhances the production of chemokines and cytokines. Indeed, peritoneal macrophages and embryonal fibroblasts from PARP-deficient mice produced significantly less macrophage inflammatory protein-1a (MIP-1a) a CC chemokine known to be responsible for the recruitment of monocytes to inflammatory environment (Virag, Hasko, and Szabo, unpublished observations). In various inflammatory models ranging from zymozan peritonitis to colitis and arthritis, in animals treated with PARP inhibitors as compared with wildtype mice, we have found a reduced number of neutrophil granulocytes as measured by myeloperoxidase...

Antibiotics Inhibit Triggering

Amor, unpublished observations). All these data indicate that persistent or repeated infection, mostly probably gut-derived, makes an important contribution to the pathogenesis and severity of AS. The mechanisms that lead from infection to autoimmunity in AS have not yet been defined.

Gelsolin In Human Diseases

However it should be noted that under normal housing conditions and without challenging the animals, the gelsolin null mice do not show any increased incidence of tumor formation (Witke W, Kwiatkowski DJ, unpublished observation), suggesting that the loss of gelsolin in cancer is perhaps a downstream event, or that loss of gelsolin has to go together with the loss of other tumor promoting genes in order to cause transformation.

Hyaluronan Structures in Solution Relevance to Tissue Biologic Functions and Aging

Proton-NMR spectroscopy data indicate that not all hexosamine in HA is N-acetylated (Longas et al., unpublished work). Therefore, the universally accepted, alternating sequence of equimolar amounts of D-GlcA and D-GlcNAc, shown in Fig. 1 (1-5), may incorporate some D-GlcN. Other regions may have sequences of D-GlcNAc only followed by at least one D-GlcA (Fig. 4) basic (Fig. 5), acidic (Fig. 6) and D-GlcNAc segments alternating with D-GlcN (Fig. 7) are also possible. Although fibroblast cultures from human skin of 75-year-old subjects synthesize HA with D-GlcNAc as its hexosamine component (Longas MO, unpublished observations), an enzyme that appears to be induced with aging and becomes highly active in the seventh decade of life is present in the skin of these individuals and cleaves the acetyl (-COCH3) group from N at position 2 of the hexosamine (77). These findings are relevant in aging, because N-deacetylated HA is more hydrophilic than the one found in young skin. The formation...

Tregulatory Cell Depletion

Ontak, DAB389IL-2 (denileukin diftitox), is a recombinant diphtheria toxin conjugate consisting of the active domain of diphtheria toxin and human interleukin 2 (IL-2). It is approved by the FDA for the treatment of cutaneous T cell leukemia lymphoma 30 . It targets cells expressing the IL-2 receptor 31,32 and is proposed to be internalized into CD25+ cells by endocytosis, where it inhibits protein synthesis, leading to apoptosis. More recent evidence demonstrates that Ontak also targets cells through components of the IL-2 receptor in addition to CD25 32,33 (also Curiel and coworkers, unpublished results). As recently activated T cells also express high-level CD25, Ontak could also deplete CD25+ effector cells. We observed effector cell depletion in some of our patients following three or more weekly Ontak infusions at 12 g kg (Curiel and coworkers, unpublished results), which has also been suggested by in vitro work 36 . An optimal balance between effector and Treg depletion may be...

Complement and DNase I Act as Backup Molecules in the Clearance Process

An impaired uptake of apoptotic cells by human macrophages was observed in human serum depleted of specific complement components (C1q, C3) 42, 64 . We observed that complement binding is an early event in necrosis and a rather late event in the case of apoptosis. Complement components, mainly C1q, C3, and C4 act as back-up mechanism to clear apoptotic cells before they enter the dangerous stage of secondary necrosis 21, 22 . Disturbed clearance of nuclear DNA-protein complexes, remnants of dying cells, may initiate and propagate SLE 4, 54 . This is further substantiated by decreased levels of DNase I activity, as had been observed in the sera of SLE patients 14 and patients with other autoimmune diseases such as rheumatoid arthritis (RA) (U.S. Gaipl et al., unpublished data). DNase I, being the major serum nuclease, may be responsible for the degradation of chromatin accidentally released by inappropriately cleared dead cells 39 . Furthermore, DNase I acts together with C1q to...

Aging Decreases Humoral Immune Responses

Investigated whether AID might also be lower in these cells. We found that unstimulated cells from both young and old mice express indiscernible levels of AID-specific mRNA. Stimulation of B cells from young mice induced an increase in mRNA expression at days three and four whereas optimal mRNA expression was attained at day five. Stimulation of B cells from old mice induced AID mRNA expression at days four and five, but the level of expression was lower (about fivefold) as compared to that exhibited by B cells from young Balb c mice (Frasca et al., 2004b Table 9.1). E47 and AID were decreased to the same extent in old versus young B cells in response to different stimuli, such as anti-CD40 IL-4 (Frasca et al., 2004b), BAFF IL-4 (Frasca et al., 2007b) or LPS (Frasca and Blomberg, unpublished data). As a consequence of the decrease in AID levels in old versus young B cells, less class switch DNA products were obtained five days after stimulation, whereas germline transcripts were...

Modulation of mCRPs for Immunotherapy

For example, using small interfering RNA (siRNA) technology, CD55 expression levels can be significantly downregulated in prostate cancer cells leading to a profound attenuation of overall tumor burden in vivo (Loberg et al. 2006). Similarly, CD46 siRNA downregulates CD46 expression on prostate cancer resulting in enhanced CDC in vitro (Buettner et al. 2007). Our recent study using CD59 siRNA showed that downregulation of CD59 on human ovarian carcinoma SKOV-3, non-small cell lung carcinoma NCI-H23, and breast carcinoma ZR-75-1 significantly enhanced their susceptibility to anti-tumor mAb and complement-mediated cell lysis (Yan R., et al. unpublished observations). Interestingly, the chemotherapeutic drug fludarabine down-regulates CD55 expression on tumor cells (Di Gaetano et al. 2001). This may well explain the synergistic cytotoxicity of fludarabine and anti-CD20 mAb (rituximab) in a follicular lymphoma cell line (Di Gaetano et al. 2001). We also showed that Paclitaxel...

Ischiofemoral Ligament

Ligamentum Teres Avulsion

And 77 to 89 for cartilage injury detection, respectively 4,62 . One of these studies showed an overreliance on secondary signs of osteoarthritis and chon-drosis (ie, increased signal intensity of subchondral marrow and osteophytes) resulted in false positive interpretation. These authors also had more difficulty assessing acetabular sided cartilage lesions. However, a more recent study using unilateral noncontrast MR described sensitivities from 86 to 93 and specificities from 72 to 88 6 . Unpublished data from our institution evaluating MRI in professional golfers found that MRI underestimated the degree of articular cartilage injury when compared with arthroscopic findings. Traumatic lateral impact injuries associated with falls onto the ground with axial loading of femoral head can be associated with hip pain and chondral impaction injury. Subchondral marrow edema may be present, but MR findings can be minimal in these cases 63 . The glenohumeral joint of the shoulder is the...

NSAIDs and AD The Epidemiological Evidence and Overview of Potential Mechanisms of Action

Other recent findings suggest that NSAIDs directly affect the amyloid pathology in AD by altering APP processing, Ap production, or Ap aggregation. First, some NSAIDs, including ibuprofen and indomethacin, were recently shown to selectively lower Ap42 production in vitro and in APP-transgenic mouse models of AD (Eriksen et al., 2003 Weggen et al., 2001). Second, Avramovich, Amit, and Youdim (2002) have proposed that ibuprofen and indomethacin potently stimulate secretion of the neurotrophic and neu-roprotective APP ectodomain (APPs) in neuronal cell lines by upregulation of the nonamyloidogenic a-secretase pathway. However, we have been unable to confirm these findings in the same cells lines as well as in primary neuronal cultures (S. Leuchtenberger, unpublished data). Third, NSAIDs were shown to interfere with Ap aggregation and fibril formation in vitro (Agdeppa et al., 2003 Hirohata, Ono, Naiki, & Yamada, 2005 Thomas, Nadackal, & Thomas, 2001 Yang et al., 2005). Fourth,...

Clinical Significance of the Trojan Horse Concept

CD20 is expressed on the surface of B cells. It is also present at a low level on a small proportion of CD3+ T cells (0-10 , mean 3 , mostly CD4-, CD8-) and a very small number of CD56+CD3- (natural killer phenotype) cells, which are also depleted by rituximab (M. J. Leandro, unpublished data Figure 21.2). CD20 is a calcium channel associated with lipid rafts (Li et al., 2004), but whether its function is involved in the action of therapeutic antibodies is not established.

Cytokines as Neuroelectric Blocking Factors

Protein libraries, however, have not been successful in identifying the putative human precursor protein (Brinkmeier et al., 2000 Quasthoff et al., 2003 Cummins and Waxman, unpublished observations). Thus, it is also not clear how QYNAD might be generated in vivo and why the concentration of QYNAD is increased in the CSF of patients with MS and GBS. Another issue that should be examined is whether QYNAD concentrations in the CSF fluctuate and, if so, whether fluctuations are correlated with clinical status. Until some of these issues regarding the role of QYNAD in demyelinating disorders can be better addressed, the conclusion that QYNAD contributes to negative symptoms in MS and related disorders should be viewed with caution.

Numeric Assessment of Adherence

The activity, and weight status of the individual (Timperio et al, 2003). Lu and colleagues (2008) reported that 1-month estimates were better than 3- or 7-day recalls when compared with EEM data. However, our own research has suggested that patients with rheumatoid arthritis may have difficulty in remembering the detail of medication taking beyond 3 days. In a 7-day recall of medication taking it was common for patients to begin to report the same beyond the third day (unpublished data). Lee et al, (2007) further reported that 24-h recalls were unrelated to pill counts and insensitive to temporal change. Thus, brief recalls may or may not correlate with concurrent clinical data. The question arises as to how much data can be reliably collected to build a picture of adherence over time.

LTi Cells and Ectopic Lymphoid Follicles in Autoimmunity

Several autoimmune diseases, including Crohn's disease, rheumatoid arthritis, and type I diabetes, are marked by formation of ectopic lymphoid organlike structures within the affected tissues. The contribution of such ectopic follicles to disease pathogenesis remains unexplored. The role of LTi cells or related inducer cells (such as those found in CPs) in these lesions has yet to be explored. Forced expression of CXCL13 BLC in pancreatic islet cells resulted in the local formation of lymphoid follicles, but this was independent of LTi cells, because follicles were also observed in RORY- -mice ( 66 and unpublished collaborative result). However, CXCL13 expression by stromal cells is induced by LT0R signaling. As LTi-like cells are the producers of LTap, this system may bypass the requirement for the cells. In autoimmune diseases, inflammatory stimuli may result in activation of LTi or CP-like cells, particularly in the intestine, and this could induce excessive follicle formation....

Immunoregulation In The Ocular Surface System

If alterations in local or systemic prolactin expression increase the tendency for activation of DCs and initiation of TH1 effector responses, local expression of TGF- may exert a countervailing influence. It is intriguing to consider that prolactin and TGF- act upon each other in the local signaling milieu. On the one hand, prolactin inhibits expression of TGF- by breast cancer cells (192). On the other hand, TGF- inhibits expression of prolactin by anterior pituitary cells (193), decidualized endometrial cells (194), and GH3 cells (195). As illustrated in Figure 3, immunopositivities for both prolactin immunoreactivity and total TGF- increase markedly within ductal epithelial cells during pregnancy (19). Preliminary results suggest that increases in systemic estrogen and progesterone levels may overcome the mutually inhibitory actions of TGF- and prolactin, since administration of estrogen and progesterone to ovariectomized rabbits appears to elicit the same pattern of changes in...

Additional antiphlogistics and antirheumatics

D-penicillamine works as a result of its structure as a chelating agent, and is therefore used as an antidote for metal poisoning and also as therapy for the copper storage illness, Wilson's disease. In addition, penicillamine has an antiphlogistic effect. In connection with prenatal exposure in (he case of maternal cystinuria, chronic polyarthritis and Wilson's disease, five cases of inborn cutis laxa - some with inguinal hemia and with further very different and serious birth defects - have been described in the literature (Pinter 2004, Rosa 1986). In contrast, there are more than 100 cases with no noteworthy effects (Sinha 2004, Tarnacka 2000, Messner 1998, Dupont 1991, as well as unpublished experience). There is no clear-cut answer to whether penicillamine is responsible for the sometimes reversible disturbances in the development of the connective tissue. If there is a teratogenic risk at all, it is very slight.

A point mutation of the ZAP70 gene as the primary cause of SKG arthritis

As the consequence of the ZAP-70W163C mutation, the tyrosine-phosphorylation status of major signal transduction molecules, including ZAP-70, TCR-Z, LAT (linker for the activation of T-cells) and PLC-y1, is extremely low in thymocytes and T-cells 17-19 . Calcium mobilization, one of the earliest events induced by TCR stimulation, is also greatly impaired in SKG thymocytes and T-cells presumably due to the reduced phosphorylation of PLC-y1. Immunoprecipitation of ZAP-70 from stimulated SKG thymocytes and T-cells fail to co-precipitate tyrosine-phosphorylat-ed p21 and p23 isoforms of TCR-Z, indicating a defective interaction between ZAP-70 and TCR-Z. SKG T-cells show no enhancement of the expression of Syk, another protein tyrosine kinase which might compensate the role of ZAP-70 in T-cells (T. Takahashi, unpublished data). Taken together, the ZAP-70W163C mutation may impair the recruitment and association of ZAP-70 to tyrosine-phosphorylated immunoreceptor tyrosine-based activation...

Modulation Of Adjuvant Arthritis Using The Arthritisassociated 180188 Epitope And Peptide Analogues

Attempts to reproduce these findings have failed because it has been found that preimmunization with IFA alone without antigen is sufficient to protect against AA (W. van Eden et al., unpublished observations, and Ref. 42). Indeed IFA-induced protection has also been found in SCW and CP20961-induced arthritis models using Lewis rats. The mechanism of this protective activity remains unknown, but it is intriguing to note that IFA-immunization without antigen has been reported to induce T-cell reactivity against hsp 65 both in mice (43) and Lewis rats (42).

2128 Other immunomodulators

Copolymer 1 (glatiramer acetate) is a mixture of synthetic polypeptides composed of four amino acids. It has been approved for use in the treatment of multiple sclerosis. The manufacturer reports that experimental reproduction studies did not uncover signs of adverse effects on fetal development (Johnson 1995). A poster presenting data of clinical trials and post-marketing surveillance from the manufacturer showed six healthy full-term infants and one with congenital anomaly during clinical trials. During post-marketing surveillance, 6 of 161 live-born had anomalies (failure to thrive, finger abnormalities, cardiomyopathy, urethrostenosis, adrenal cyst, and anen-cephaly) (Coyle 2003), Among more than 30 live-boms there was one infant with clubfeet (unpublished experience of the European Network of Teratology Information Services, ENTIS).

Immunopathology of arthritis in SKG mice

Serologically, SKG mice develop high titers of rheumatoid factor (RF), autoanti-bodies specific for type II collagen, antibodies reactive with heat shock protein (HSP)-70 of Mycobacterium tuberculosis presumably due to cross-reaction with a conserved epitope of HSP, severe hypergammaglobulinemia, and high concentration of circulating immune complexes, but no significant titer of anti-DNA antibodies or organ-specific autoantibodies such as anti-thyroglobulin autoantibody. Some SKG mice develop anti-cyclic citrullinated peptide (CCP) antibody (M. Hashimoto et al., unpublished data) 14 . Proinflammatory cytokines such as TNF-a, IL-1, IL-6 are abundantly produced in the affected joints 15 . Furthermore, the incidence and severity of SKG arthritis is significantly reduced when the mice are rendered TNF-a, IL-1 or IL-6-deficient, similar to the effects of anti-cytokine therapy in human RA 2, 15 . Notably, cytokine-deficient SKG mice free of arthritis still develop RF and anti-CCP antibody,...

Phoebe A Kaplan and Robert G Dussault

Robert Dussault

Clinical improvement after blind steroid injections for plantar fasciitis has been reported in 35 to 70 of people (5,6). The highest rate of pain relief was in a group where each patient routinely received five to six injections. There are few reports of response to image-guided injections. One study that utilized bone scans to guide the injections in 15 patients had an 80 response rate (7). A report of ultrasound-guided injections (3) on the heels of five patients showed four with a positive response (80 ). We reviewed a group of 28 of our patients who had magnetic resonance imaging proof of plantar fasciitis and recalcitrant and long-standing pain. These patients were injected using fluoroscopic guidance. Follow-up at one year or more after a single injection showed 79 with continued pain relief (unpublished data). Image guidance seems to increase the response rate as well as decrease the number of injections necessary because the steroid is being deposited at the proper location...

Role of iNKT Cells in the Pathogenesis of Type 1 Diabetes

An iNKT cell deficiency arising from a block in iNKT cell development after thymectomy on day 3 causes gastritis in (BALB c x C57BL6) F1 mice (Hammond et al., 1998). This suggests that significant iNKT cell development occurs early in life to prevent autoimmunity. Previously, an NKT cell deficiency was reported as early as 3 weeks of age in NOD mice (Gombert et al., 1996). Interestingly, our real time PCR analyses of Va14Ja18 expression indicate that this iNKT cell deficiency may be present even earlier at 1 week of age in an NOD thymus (our unpublished data), a time point considered to be the immunological equivalent of a newborn human (Adkins et al., 2004). Our finding raises the possibility that an iNKT cell deficiency may be present at birth and may predispose NOD mice to the development of T1D. Precursors in the iNKT cell pathway, e.g., CD44low iNKT or DP thymocytes, need to be examined for the expression of Va14Ja18 TCR to determine the earliest stage at which the iNKT cell...

The Role of Proinflammatory Cytokines in Arthritis

Particularly affected (Fig. 2). hTNFa was found to be overexpressed in various tissues, including lung, spleen, and the joint and it is not obvious why the joint should be affected pathologically whereas other tissues were apparently normal. Indeed, a second strain of TNFa over-expressing mice was generated in which the AU-rich region of the TNFa transgene was deleted by targeted disruption and these mice developed not only arthritis but also inflammatory bowel disease (24). It is noteworthy that TNFa over-producing mice can be back-crossed to RAG - mice without altering the arthritis phenotype, indicating that TNFa is mostly downstream of the T- or B-cell response. Furthermore, we have been unable to detect autoantibodies to cartilage-derived proteins (type II collagen, type IX collagen, type XI collagen, or aggrecan) in hTNFa transgenic mice on a DBA 1 background (unpublished data).

Modulation Of Arthritis Using Recombinant Mycobacterial

This correlation of T-cell responsiveness to hsp 65 and protection against AA might account for results of experiments using Fisher rats. Although Fisher rats and Lewis rats share the same MHC class II alleles (RT1.B1 and D1), Lewis rats are susceptible to AA, whereas Fisher rats are resistant. Thus, there appears to be a non-MHC genetic control over susceptibility. Interestingly, Fisher rats maintained in germ-free conditions are susceptible to AA (50). This was reversed by oral administration of E. coli 4 weeks prior M. tuberculosis immunization (51). It is reasonable to assume that this E. coli treatment might increase immune reactivity to GroEL (the E. coli hsp 60 homologue), and this might account for the AA-protective activity. One report suggested that the discrepancy between Lewis and Fisher rats regarding AA susceptibility was due to a lack of T-cell reactivity to the 180-188 epitope in Fisher rats. However, we have demonstrated recently that following immunization with hsp...

The Inflammatory Trio TNFa TGFp IL6

Conversely, TNF-a produced by tumor cells or inflammatory cells may promote tumor survival via the induction of anti-apoptotic genes controlled by NF-kB activation. Indeed, TNF-a has been demonstrated to promote tumorigenesis as TNF-a deficient mice or mice treated with anti-TNF-a antibodies are largely protected from the chemical induction of skin papillomas (Moore et al. 1999 Scott et al. 2003). TNF-a - - mice are also very proficient at rejecting syngeneic murine tumor models implanted orthotopically (Mumm and Oft unpublished). By fostering the production of genotoxic reactive oxygen species and nitric oxide, TNF-a may also directly increase the mutation rate in tumors (Szlosarek et al. 2006). In addition TNF-a also plays a role in the truncation of an adaptive immune response. Through regulation of Fas FasL, TNF-a can drive activation induced cell death (Elzey et al. 2001). TNF-a may therefore induce apoptosis of activated tumor infiltrating T cells, thereby blunting adaptive...

Antiinflammatory Drug Trials In Ad Future Directions

Sub-threshold levels (Pasinetti, unpublished observation). Thus, it would not be unexpected that non-selective COX inhibitors, such as ibuprofen, might also affect COX-2 neuronal metabolic activities independent of glial inflammatory. We also note that ibuprofen may suppress plaque pathology and inflammation in a mouse model of AD neuropathology (Lim et al., 2000). In addition, we will address the possible contribution of COX-2 on cytokine expression and activation of the complement cascade during the clinical progression of AD dementia. Two pharmaceutical companies are now conducting large-scale trials of selective COX-2 inhibitors to slow the progression of AD one of these trials, using rofecoxib (Vioxx), targets the earliest stage of the disease (i.e. slowing the progression from questionable to mild dementia).

Limitations Benefits and Methods in Testing Individual Differences

As discussed earlier, the results of behavioral studies of aging in nonhuman primates suggest that establishing a universal description of the aging process may be difficult using cross-sectional research designs. One complication of this type of research is that there are often large individual differences between individuals within the same age group (Tarou et al., 2002). For example, in a study of aging chimpanzees at the Yerkes Primate Research Center, one 43-year-old chimpanzee showed severe signs of senescence, spending large amounts of time inactive, likely as the result of arthritis and glaucoma, whereas another chimpanzee of the same age, living in the same environment, spent more time engaged in active behavior and appeared to be unaffected by senescent changes (Tarou, unpublished data). These individual differences could be the result of heritable or environmental differences in disease susceptibility and transmission. However, they could also indicate individual behavioral...

Heterogeneity in peripheral blood cells

Gene expression profiling in whole blood cells from RA patients revealed significant variation between RA patients that allows stratification of patients on the basis of distinct molecular characteristics (Tineke van der Pouw-Kraan, Carla Wijbrandts, Paul-Peter Tak en Cornelis Verweij, unpublished observations). Analysis of the differentially expressed gene clusters using gene set analysis, such as PLAGE (www.cbcb.duke.edu pathways ) and Panther (www.panther.appliedbiosys-tems.com), indicated that distinct inflammatory processes are active in different subsets of patients. So far the clinical relevance of the molecular differences remains to be established.

Most frequent HIVassociated skin diseases

Xerosis Dry skin Dry skin is a very frequent complication of any kind of immunodeficiency. In the pre-HAART-era, we diagnosed dry skin in one in three HIV-infected patients (see Table 1). The patients complain of dry, itchy skin, which is exacerbated by any stimulus. Overall, these skin problems are very much like atopic dermatitis (Rudikoff 2002) and can culminate in acquired ichthyosis. The prevalence of dry skin in HIV-infected patients decreased after the introduction of HAART, but is sometimes seen in patients on indinavir (Garcia-Silva 2000). Some years ago, we showed that the lipid film of the skin surface has a different composition in HIV-infected patients, but is not diminished in quantity (C. Semrau unpublished data, doctoral thesis).

C3a Receptors Signaling in Mast Cells

In resting cells, most of the NF-kB is bound to a potent inhibitor IkB, thus retaining this complex in the cytoplasm (Ghosh and Karin 2002). Upon cell activation IkB is phosphorylated by IkB kinase (IKK) leading to its proteosomal degradation. NF-kB, once dissociated from IkB, rapidly translocates to the nucleus where it binds to specific promoters of the target genes. Although several IkB isoforms are known, Gao et al., (Gao, Sun, Wu, Luan, Wang, Qu, and Pei 2004) made the surprising observation that P-arrestin 2 directly interacts with IKBa to inhibit GPCR-mediated NF-kB activity. Witherow et al (Witherow, Garrison, Miller, and Lefkowitz, 2004), showed that although both P-arrestin 1 and P-arrestin 2 associate with IKBa as well as upstream kinases such as IKKa, IKKP and NIK, only P-arrestin 1 inhibits NF-kB activity and cytokine production. Our recent studies with platelet activating factor receptor (PAFR) demonstrated that receptor phosphorylation is required for...

Hypocretin Deficiency In Narcolepsy An Autoimmune Process

Among HLA-associated diseases, narcolepsy shows one of the tightest positive associations with specific HLA alleles (DQBl*0602 and DQAl*0l02). DQBl*0602 confers disease susceptibility. A similar HLA allele, DQBl*060l, is, however, protective. The P4 and P9 pockets differ significantly between DQ*0602 and DQ*060l, suggesting that differential peptide binding between these two is critical for a positive or negative risk to develop narcolepsy (99). Hypocretin itself may fit the P4 pocket, but no antibodies directed against hypocretin-l, hypocretin-2, or preprohypocretin have been detected in narcoleptic patients (Mignot, unpublished data). Most investigations, however, have failed to provide conclusive evidence of a causal role of HLA alleles in the pathogenesis of narcolepsy (83-86). This led to the hypothesis that HLA-DR2 was a linkage marker for a gene that caused narcolepsy. Analysis of microsatellite polymorphisms in the area immediately flanking DQBl*0602 and DQAl*0l02, however,...

Heat Shock Proteins And Juvenile Chronic Arthritis

Lining cells and endothelial cells and macrophages, all with a high level of expression of HLA-DR (11,16). The pattern of expression of human hsp 60 in synovial membranes of patients with JCA as detected by LK-1 parallelled exactly the staining pattern of the antibodies, ML-30, TB-78, and F-8 (unpublished observations by the authors). The cross-reactive LK-2 antibody also showed a similar staining pattern. With exception of F-8, it seems likely that cross reactivity with human hsp 60 was the basis for this result. The monoclonal antibody F-8 recognizes the 180-188 amino acid sequence of mycobacterial hsp 60, a sequence not present in human hsp 60. Overall it can be concluded that both endogenous hsp 60 and microbial hsp 60 may be expressed in synovial tissue of patients with JCA and that hsp 60 is localized mainly in synovial lining cells, endothelial cells of blood vessels, and macrophages.

Clinical Picture

APECED is a multicomponent disease (see Table 2) with a widely variable clinical picture (2,47-50). Its most common components are mucocutaneous candidiasis, hypoparathyroidism, and adrenocortical insufficiency, but more than 10 other components may occur. The following description is mainly based on our experience with 89 Finnish patients (45 males and 44 females) (Perheentupa J, unpublished).


Regarding the clinical response the picture is already emerging that the potency of this treatment seems to be overall below that of other promising approaches such as the anti-TNF-a strategies. Thus, a complete disease clearance is usually a rare event after IL-10 application, suggesting a relatively low anti-inflammatory potential for this therapy. Moreover, a recent report23 and our recent unpublished observations suggest even pro-inflammatory properties of IL-10. In agreement with this we observed an increase of the sIL-2R levels in IL-10 long-term-treated patients. Therefore, we speculate that IL-10 might not be the major break through in anti-inflammatory therapy of exacerbated disease. In contrast, impressive clinical


In humans, a difference was noticed in the capability to respond to human hsp 60 between children and adults. A significant and reliable response of mononuclear cells from both the peripheral blood and the synovial fluid to human hsp 60 was found in children with JCA. Probably with the exception of very early cases of reumatoid arthritis, proliferative responses to human hsp 60 are not seen in adults. From the comparison of patients in different subgroups of JCA, it became evident that patients with the oligoarticular onset of JCA (OA-JCA) the response is associated with the active phase of the disease. In case of remission of the disease, the response to human hsp 60 disappeared (Fig. 2). In the subgroups of polyarticular or systemic JCA, we documented less frequently positive responses to human hsp 60, and these responses did not show any correlation with the disease activity. Clinical relapse of arthritis patients with OA-JCA coincided with reappearance of anti-human hsp 60...

Mental health

Both of the studies discussed above have been included in a recent meta-analysis of all the double-blind, controlled clinical trials of acetyl-L-carnitine.6 The study concentrated on patients treated with acetyl-L-carnitine who had mild cognitive impairment or mild Alzheimer's disease, and found that of 21 studies conducted, 17 showed that acetyl-L-carnitine had a positive effect on patients this included some unpublished trials. The meta-analysis used two endpoints for its results the CGI used in most studies and the Integrated Summary of Clinical Tests


A second criteria of quality is the credibility of the sources presenting the evidence 16 . Journals like BMJ and Work that bring us the patients' voices are credible in that they are peer-reviewed and are regarded as being 'high-quality' by their readers. Narrative evidence presented in books from large publishing houses like Harpers, who published Grealy's work, have more credibility then those that are self-published. Morris 2 . Scarry 3 . Good 17 and Frank 6 . all present their academic credentials as demonstration of their credibility. In the case of Brenda's story, the DIPEx site 4 is supported by the National Health Services (NHS) in the United Kingdom and is a registered charity. DIPEx makes available information about its structure and board on the website. DIPEx was also voted by two leading national newspapers in the UK as being among the top health websites providing evidence that the resource is well respected by credible reviewers.

Pathway Analysis

To investigate this possibility we looked to the mouse. In the mouse there is an arthritis QTL identified that contains the Ncfl gene. However, we found that Ncfl was not polymorphic and we did not find an effect on the oxidative burst using a congenic strain with a fragment derived from C3H on a B10.Q background (P. Olofsson et al., unpublished data). Another mouse that was made deficient for Ncfl was not possible to use for our purpose, as the mutation results in a complete destruction of the gene. Moreover, the Ncfl-targeted mutation also contains a genetically linked 129-derived fragment 25 ,known to contain other polymorphic genes of importance for arthritis 26 . However, a worldwide search through available mouse strains identified a variant of a C57B1 6 strain with mutations in both the leptin receptor and the Ncfl gene 27 . The point mutation in the Ncfl gene is located at position -2 in


Derived from subject X19, suggesting normal expression from the unaffected allele the absence of a detectable unspliced form of the mRNA suggests that the mutant allele is not expressed. The function of the normal ZFP36L1 protein in physiology is unknown. However, when it is expressed in human embryonic kidney 293 cells, the ZFP36L1 protein can, like TTP and ZFP36L2, promote the instability of ARE-containing mRNAs following direct binding to the class II ARE (1). In addition, its expression is increased in a form of acute myelogenous leukemia, where its overexpression is associated with enhanced myeloid cell proliferation in response to granulocyte colony-stimulating factor (33). Recent experiments with the mouse gene knockout indicate that total deficiency of Zfp36L1 is lethal in early gestation, suggesting that even the hemizygous state might be associated with a disease or trait (D. J. Stumpo, R. S. Phillips, Y. Mishina and P. J. Blackshear, unpublished data). We are currently...

Multiplex Hypothesis

The multiplex hypothesis is designed to embrace, as well as the well-known MHC-restricted chaperonin actions, all non-MHC-restricted effects of chaperonins that are beginning to emerge. These include (see Table I) MHC-unrestricted (Silva et al, 1993) a 3 T lymphocyte targets, yS T cells (O'Brien et al., 1992 Born et al., 1990 Kaur et al., 1993), monocytes (Friedland et al., 1993 Peetermans et al., 1994), and synovial fibroblast-like cells (F. Marelli, P. Mascagni, and A. R. M. Coates, unpublished data, 1995). In addition chaperonins may be involved in the growth and development of other cells if cpnlO is indeed early pregnancy factor (Cavanagh and Morton, 1994). For example, chaperonins may be involved in the induction of apoptosis, or programmed cell death. Work by Galli et al. (G. Galli, P. Ghezzi, P. Mascagni, F. Marcucci, and M. Fratelli, unpublished data, 1995) suggests that M. tuberculosis cpnlO induces apoptosis of human T lymphocytes. This interesting finding may herald other,...

Human Studies

That are specific for shared epitopes of bacterial and human chaperonins have been reported in reactive and juvenile arthritis (de Graeff-Meeder et al, 1991 Hermann et al, 1991). It is interesting that two CD4+ T cell clones from a patient with juvenile arthritis recognize cross-reactive epitopes in the 243-265 amino acid region, which is highly conserved between mycobacteria and mammals (Quayle et al, 1992). This region is also recognized by T cells in adjuvant arthritis in rats (Anderton et al, 1994). However, there is some doubt about whether T cells in the synovial fluid of juvenile arthritis cross-react with human cpn60. In this type of arthritis, bacterial cpn60-specific T cells do not respond to heat-shocked human cells that might be expected to express human cpn60 (Life et al, 1993), although they do react to E. coli cpn60, which contaminates many recombinant cpn60 preparations. This observation provides evidence against the molecular mimicry hypothesis. Simple cross-reaction...


In the systematic review all published and unpublished randomized clinical trials that compared at least 12 weeks of celecoxib treatment with placebo or a traditional NSAID (di-clofenac, ibuprofen, naproxen) were analysed. Nine of 17 trials fulfilled the inclusion criteria (a total of 15187 patients). Withdrawals because of drug-related gastrointestinal adverse effects, ulcers detected at endoscopy, and complicated ulcers were used as measures of gastrointestinal tolerability. Compared with those taking non-selective NSAIDs, the patients who took celecoxib had a lower rate of withdrawals because of adverse gastrointestinal effects at 12 weeks (3.2 vs 6.2 ), but there was no significant difference between celecoxib and NSAIDs in the incidence of withdrawals for all adverse events. The incidence of ulcers detected at routine endoscopy at 12 weeks was also lower in patients who took celecoxib compared with those who took non-selective NSAIDs (6.2 vs 23 ). In four trials that provided...


Suggestions for improved gastrointestinal safety of COX-2-selective inhibitors have come from two studies, which addressed the problem of sample size by pooling published and unpublished randomized, double-blind trials of varying design and duration, comparing cele-coxib, rofecoxib, non-selective NSAIDs (diclofenac, ibu-profen, nabumetone), and placebo in patients with osteoarthritis and or rheumatoid arthritis. described on the FDA website, the published account of CLASS differed from the original protocol in many respects (in primary outcomes, statistical analysis, and trial duration). In particular, the published article represented selective reporting of the combined analysis of only the first 6 months of two separate protocols of longer duration the first a 12-month comparison of celecoxib with diclofenac and the other a 16-month comparison of celecoxib with ibuprofen. The unpublished data show that by week 65 celecoxib was associated with a similar number of ulcer complications...

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