Prevalence and Predictors of Immunological Failure among HIV Patients on HAART in Southern Ethiopia

Immunological monitoring is part of the standard of care for patients on antiretroviral treatment. Yet, little is known about the routine implementation of immunological laboratory monitoring and utilization in clinical care in Ethiopia. This study assessed the pattern of immunological monitoring, immunological response, level of immunological treatment failure and factors related to it among patients on antiretroviral therapy in selected hospitals in southern Ethiopia. A retrospective longitudinal analytic study was conducted using documents of patients started on antiretroviral therapy. Adequacy of timely immunological monitoring was assessed every six months the first year and every one year thereafter. Immunological response was assessed every six months at cohort level. Immunological failure was based on the criteria: fall of follow-up CD4 cell count to baseline (or below), or CD4 levels persisting below 100 cells/mm³, or 50% fall from on-treatment peak value. A total of 1,321 documents of patients reviewed revealed timely immunological monitoring were inadequate. There was adequate immunological response, with pediatric patients, females, those with less advanced illness (baseline WHO Stage I or II) and those with higher baseline CD4 cell count found to have better immunological recovery. Thirty-nine patients (3%) were not evaluated for immunological failure because they had frequent treatment interruption. Despite overall adequate immunological response at group level, the prevalence of those who ever experienced immunological failure was 17.6% (n=226), while after subsequent re-evaluation it dropped to 11.5% (n=147). Having WHO Stage III/IV of the disease or a higher CD4 cell count at baseline was identified as a risk for immunological failure. Few patients with confirmed failure were switched to second line therapy. These findings highlight the magnitude of the problem of immunological failure and the gap in management. Prioritizing care for high risk patients may help in effective utilization of meager resources.     

The questionable immunogenicity of certain neoplasms

Summary The possibilities of immunological intervention in neoplastic diseases are discussed in light of the accumulating findings that many spontaneously arising tumors of animals are not immunogenic in the host of origin or are not susceptible to immunological attack, and of the doubts as to the existence of tumor-associated antigens for many human neoplasms. Although some spontanous tumors do in fact display immunogenic properties and are subject to cytotoxic immune reactions, there are persuasive arguments for anticipating that a large proportion of naturally appearing malignant growths will be found to lack both immunogenicity and sensitivity to immunological effector mechanisms in the course of the host-tumor association. Even in the case of such tumors, however, significant opportunities for therapy and prophylaxis by extrinsic immunological manipulation remain cogent, as do eventualities of immunodiagnosis. These possibilities are discussed. It is concluded that whereas the simplistic assumptions which for some years set expectations in the field of tumor immunology must now be abandoned, reassessment of the nature of immunological parameters of host-tumor relationships and of the scope of immunological intervention on the basis of the information now available suggests that the immunological approach to the control of cancer continues to be a profitable area of investigation.     

当归多糖对免疫细胞增殖作用的实验研究

探讨当归多糖对免疫细胞的直接和间接作用。用MTT法分别检测当归多糖(PCA)对PBMC的直接作用、PCAPBMC培养液对PBMC的间接作用;用流式细胞术检测PCA作用于健康人PBMC后各种免疫细胞表型的改变;检测PCA注射BALB／c小鼠后脾细胞增殖变化和巨噬细胞的吞噬能力。当归多糖对PBMC具有直接的抑制作用,而当归多糖PBMC培养液可促进PBMC增殖。PCA注射BALB／c小鼠后脾细胞增殖能力和巨噬细胞吞噬能力均得到了不同程度的增强。研究结果为进一步阐明当归多糖的免疫机理提供了理论依据。     

In vivo polarization of IFN-gamma at Kupfer and non-Kupfer immunological synapses during the clearance of virally infected brain cells

Kupfer-type immunological synapses are thought to mediate intercellular communication between antiviral T cells and virally infected target Ag-presenting brain cells in vivo during an antiviral brain immune response. This hypothesis predicts that formation of Kupfer-type immunological synapses is necessary for polarized distribution of effector molecules, and their directed secretion toward the target cells. However, no studies have been published testing the hypothesis that cytokines can only form polarized clusters at Kupfer-type immunological synapses. Here, we show that IFN-gamma and granzyme-B cluster in a polarized fashion at contacts between T cells and infected astrocytes in vivo. In some cases these clusters were found in Kupfer-type immunological synapses between T cells and infected astrocytes, but we also detected polarized IFN-gamma at synaptic immunological contacts which did not form Kupfer-type immunological synaptic junctions, i.e., in the absence of polarization of TCR or LFA-1. This indicates that TCR signaling, which leads to the production, polarization, and eventual directed secretion of effector molecules such as IFN-gamma, occurs following the formation of both Kupfer-type and non-Kupfer type immunological synaptic junctions between T cells and virally infected target astrocytes in vivo.     

免疫法筛选酵母HSA-IL-11融合蛋白转化子

报道了一种筛选高表达融合蛋白HSA-IL-11的毕赤酵母转化子的免疫双膜筛选法.将生长在醋酸纤维素滤膜上的转化子进行原位诱导,再用硝酸纤维素滤膜对表达的蛋白进行原位捕捉,并经封闭过夜后使用抗HSA抗体进行免疫杂交,再用标记二抗进行显色.根据显色强弱将转化子分为强阳性、中等和阴性三类,再用抗IL-11抗体进行复筛验证.结...     

BrdU related direct revelation of typical dynamic R- and G-banding with the use of monoclonal anti-BrdU antibody.

Pulse 5-bromodeoxyuridine (5-BrdU) incorporation during the last S-phase is known to produce R- or G-banded chromosomes after photolysis-plus-Giemsa (FPG) staining. The authors applied an immunological staining with monoclonal anti-BrdU antibody instead of the FPG protocol. The results offered banded chromosomes with an immunological typical R-banding (RBI) on the GBG cultivated cells (early pulse incorporation), and an immunological G-banding (GBI) on the RBG cultivated ones (late pulse incorporation). After a further FPG protocol following an immunological treatment, an inverted banding pattern became evident whereas a faint immunological staining remained. Thus the method superimposed a GBG-banding on the RBI-staining or a RBG on the GBI one. This allows a rapid and easy R and G double chromosomal identification on the same metaphase cell, using first the immunological banding then the classical FPG staining. The method allows a reproducible dynamic G-banding with an easy monitored late 5-BrdU pulse incorporation specially attractive in spontaneous dividing cells from bone marrow. This dynamic G-banding protocol should be extended to chorionic villi and malignant cells. Our data are in agreement with a connection between dynamic banding and chromosomal portions containing or not BrdU. The lack of an immunological staining after the FPG protocol has been noticed and assume the photolysis degradation-elution of the DNA in BrdU-substituted areas.     

人附红细胞体感染FMMU白化豚鼠的研究

用附红细胞体分别感染FMMU白化豚鼠和普通花色豚鼠,同时测定两组豚鼠的红细胞免疫功能,探讨FMMU白化豚鼠的免疫学特性与病原体敏感性之间的关系。结果表明,FMMU白化豚鼠对人附红细胞体比普通花色豚鼠敏感。封闭群FMMU白化豚鼠有独特的免疫学特性,红细胞免疫功能低于普通花色豚鼠,对病原体敏感性高于普通花色豚鼠,更适于建立感染性疾病动物模型。     

IgE-containing immune complexes in bronchial asthma]

Level of circulating immunological complexes and their immunoglobulin content have been determined in 36 asthmatic patients, including 15 patients with atopic asthma and 21 patients with infectious asthma. A technique of staphylococcal protein A binding has shown, that the level of the circulating immunological complexes is increased in patients with infectious bronchial asthma. An amount of IgE in these complexes has been increased in both atopic and infectious bronchial asthma. However, a level of IgE-containing immunological complexes has been higher in the atopic asthma, then that in infectious form of the disease. An increased IgA content in the immunological complexes has been noted in the infectious asthma.     

海珠益肝胶囊对免疫性肝损伤模型小鼠的保护作用

目的：观察海珠益肝胶囊对卡介苗（BCG）加脂多糖（LPS）诱导的小鼠免疫性肝损伤的防护作用。方法：采用卡介苗（BCG）加脂多糖（LPS）诱导小鼠免疫性肝损伤,通过检测小鼠的血清谷丙转氨酶（ALT）和谷草转氨酶（AST）活性及肝脏病理变化来研究海珠益肝胶囊的保肝功能。结果：海珠益肝胶囊防治组小鼠血清ALT及AST活性比模型组显著降低,两组比较,差异有统计学意义。海珠益肝胶囊可明显减轻肝组织病理损伤,以大剂量组作用最佳;海珠益肝胶囊的使用使免疫性肝损伤小鼠肝细胞凋亡减少,且有剂量依赖关系。结论：海珠益肝胶囊对BCG加LPS诱导小鼠产生免疫性肝炎的模型免疫性肝损伤具有显著的保护作用。     

From Tango to Quadrilla: Current Views of the Immunological Synapse

All T cell functions require establishing contacts with other cells. In the last ten years, the immunological synapse, the contact-site between T cells and their partners, has been the object of numerous investigations and recent advances in imaging technologies have provided significant insights into the mechanism of immunological synapse formation and its functional outcomes. Considering all the available data, the immunological synapse can be defined as a dynamic structure, formed between a T cell and one or more antigen-presenting cells, showing lipid and protein segregation, signaling compartmentalization, and bidirectional information exchange though soluble and membrane-bound transmitters. In this review, we present the current views on the immunological synapse and discuss about some interesting unresolved questions.Key words: T lymphocyte, immunological synapse, signaling, microcluster, TCR, lipid raft, costimulation     

The immunological function of allosuckling

Young mammals are unable to mount an efficient immune response against invading pathogens. Until their immune system is mature mothers transmit to their young immunological compounds during lactation. Given that genetic and foster mothers can assume this protective role, we propose that young mammals may gain immunological benefits by suckling more than one nursing female, a behaviour referred to as "allosuckling". This hypothesis has so far not been considered as a potential explanation for the propensity of young mammals to suckle foster mothers. However, pathogen transmission through milk during allosuckling may reduce the immunological net benefit that young gain, and furthermore allosuckling may increase pathogen transmission between foster and genetic mothers implying costs of allosuckling for all participants. Here, we develop the immunological function of allosuckling hypothesis (IFA) as a potential explanation for intra-and interspecific variation in allosuckling frequency. We present published experimental evidence for the assumption that immunological benefits of allosuckling depend on the immunological status of the offspring, the foster and the genetic mothers. Finally, we give predictions arising from the IFA hypothesis and propose that the IFA may provide a new explanation as to why neonates suckle various females and why foster females often refuse to nurse nonoffspring.     

Depression and stimulation of immunologic memory by typhoid lipopolysaccharide and polysaccharide]

The effect of typhoid lipopolysaccharide (LPS) and polysaccharide (PS) on immunological memory in the system of IgM and IgG synthesis and rosette-forming cells was studied. When introduced into animals previously immunized with SRBC, PS stimulated, under certain conditions, immunological memory in the system of IgM synthesis and rosette-forming cells, while the injection of LPS induced only an insignificant stimulation of immunological memory. No stimulation in the system of IgG synthesis was observed after the injection of both LPS and PS. The suppression of immunological memory was noted in the animals receiving LPS as well as in those receiving PS the immunosuppressing effect produced by LPS was more pronounced.     

Linking immunological and epidemiological dynamics of HIV: the case of super-infection

In this paper, a two-strain model that links immunological and epidemiological dynamics across scales is formulated. On the within-host scale, the two strains eliminate each other with the strain with the larger immunological reproduction persisting. However, on the population scale superinfection is possible, with the strain with larger immunological reproduction number super-infecting the strain with the smaller immunological reproduction number. The two models are linked through the age-since-infection structure of the epidemiological variables. In addition, the between-host transmission and the disease-induced death rate depend on the within-host viral load. The immunological reproduction numbers, the epidemiological reproduction numbers and invasion reproduction numbers are computed. Besides the disease-free equilibrium, there are two population-level strain one and strain two isolated equilibria, as well as a population-level coexistence equilibrium when both invasion reproduction numbers are greater than one. The single-strain population-level equilibria are locally asymptotically stable suggesting that in the absence of superinfection oscillations do not occur, a result contrasting previous studies of HIV age-since-infection structured models. Simulations suggest that the epidemiological reproduction number and HIV population prevalence are monotone functions of the within-host parameters with reciprocal trends. In particular, HIV medications that decrease within-host viral load also increase overall population prevalence. The effect of the immunological parameters on the population reproduction number and prevalence is more pronounced when the initial viral load is lower.     

The embryo as allograft

The main problems and experimental results with respect to the mechanism by which the embryo, as "allograft", is tolerated within the maternal organism are reviewed. The following hypotheses are discussed: the immunological "immaturity" of the embryo and of its appendages; the immunological incompetence of the maternal organism; the uterus as an immunologically "privileged" area; the existence of an immunological barrier between the mother and the embryo.     

CD28 interaction with filamin-A controls lipid raft accumulation at the T-cell immunological synapse

During physiological T-cell stimulation by antigen presenting cells (APCs), a major T-cell membrane rearrangement is known to occur leading to the organization of 'supramolecular activation clusters' at the immunological synapse. A possible role for the synapse is the generation of membrane compartments where signalling may be organized and propagated. Thus, engagement of the costimulatory molecule CD28 at the immunological synapse promotes the organization of a signalling compartment by inducing cytoskeletal changes and lipid raft accumulation. We identified the actin-binding protein Filamin-A (FLNa) as a novel molecular partner of CD28. We found that, after physiological stimulation, CD28 associated with and recruited FLNa into the immunological synapse, where FLNa organized CD28 signalling. FLNa knockdown by short interfering RNA (siRNA) inhibited CD28-mediated raft accumulation at the immunological synapse and T-cell costimulation. Together, our data indicate that CD28 binding to FLNa is required to induce the T-cell cytoskeletal rearrangements leading to recruitment of lipid microdomains and signalling mediators into the immunological synapse.     

~1H-NMR用于肺炎链球菌荚膜多糖质量控制的尝试

纯化的6B、18C血清型肺炎链球菌荚膜多糖用生化试验和免疫学试验检测分析后再用一维氢谱核磁共振波谱(1H-NMR)法分析。生化检测其相应多糖的主要化学基团含量是否合格,免疫学检测旨在了解多糖纯化工艺是否影响了多糖的抗原活性,并间接佐证纯化多糖的生化特性是否正确。在此基础上进行1H-NMR分析,可以对纯化多糖的特性有进一步的了解。结果表明,常规的生化检测试验和免疫学检测试验并联合应用1H-NMR分析法后可更好地控制纯化肺炎链球菌荚膜多糖的质量。     

The pathogenesis of chronic lymphocytic leukemia. II]

Starting from a survey of the present knowledge of morphological, immunological and biochemical characteristics of lymphocytes degenerated in leukamic respect and their kinetics, proposals are made for the pathogenesis of chronic lymphatic leukaemia (CLL). The fact that a progressing restriction of the functional immunological variety will occur in the typical CLL is discussed. Besides normal T and B cells there are elements similar to B and T cells whose percentage of proportion changes in the course of the illness with diminution of function and increasing immunological defect.     

Immunological agglutination kinetics of latex particles with covalently immobilized antigens

Hen egg-white lysozyme (HEL), ovalbumin and bovine serum albumin (BSA) were covalently immobilized onto styrene/methacrylic acid [P(St/MAA)] copolymer latex particles by the carbodiimide method. The initial rates of the immunological agglutination of these particles initiated by the addition of antibodies were quantified by the absorbance changes at a wavelength of 680 nm. The sensitivity of the immunological agglutination of the particles with covalently immobilized antigens was higher than that with physically adsorbed ones. The immunological agglutination kinetics showed a similar tendency irrespective of antigen-antibody systems. That is, the initial agglutination rates (i) increased with increasing immobilized amount of antigens, (ii) were largest in the ionic strength range of 0.02 to 0.05 at pH 7 and (iii) decreased with increasing pH. These results indicate that the electrostatic interactions of particle-particle and particle-antibody are main factors which control the immunological agglutination. On the other hand, the sensitivity of the immunological agglutination increased with increasing molecular size of antigens.     

The Functions of the Thymus

In rodents the thymus performs at least two functions. It is a major site of lymphopoiesis in the embryo and newborn, with the resulting lymphocytes migrating from the thymus to seed the spleen, lymph nodes and other lymphoid organs. In addition, the thymus produces a hormone which has an immunotrophic effect, i.e. it endows cells having immunological potential with immunological competence. In some animals other organs, in addition to the thymus, are responsible for directing the normal development of the immunological system. These are the bursa of Fabricius in birds and the appendix in rabbits. In humans it has been postulated that the tonsillar tissues may play an analogous role. Animal experiments involving extirpation of the immunotrophic lymphoid tissues have led to a better understanding of immunological deficiency diseases in man.     

MHC class II-peptide complexes and APC lipid rafts accumulate at the immunological synapse

Activation of CD4(+) Th cells requires their cognate interaction with APCs bearing specific relevant MHC class II-peptide complexes. This cognate interaction culminates in the formation of an immunological synapse that contains the various proteins and lipids required for efficient T cell activation. We now show that APC lipid raft membrane microdomains contain specific class II-peptide complexes and serve as platforms that deliver these raft-associated class II molecules to the immunological synapse. APC rafts are required for T cell:APC conjugate formation and T cell activation at low densities of relevant class II-peptide complexes, a requirement that can be overcome at high class II-peptide density. Analysis of confocal microscopy images revealed that over time APC lipid rafts, raft-associated relevant class II-peptide complexes, and even immunologically irrelevant class II molecules accumulate at the immunological synapse. As the immunological synapse matures, relevant class II-peptide complexes are sorted to a central region of the interface, while irrelevant class II molecules are excluded from this site. We propose that T cell activation is facilitated by recruitment of MHC class II-peptide complexes to the immunological synapse by virtue of their constitutive association with lipid raft microdomains.