Polysaccharide-Specific Memory B Cells Predict Protection against Experimental Human Pneumococcal Carriage

Rationale: We have previously demonstrated that experimental pneumococcal carriage enhances immunity and protects healthy adults against carriage reacquisition after rechallenge with a homologous strain. Objectives: To investigate the role of naturally acquired pneumococcal protein and polysaccharide (PS)-specific immunity in protection against carriage acquisition using a heterologous challenge model. Methods: We identified healthy volunteers that were naturally colonized with pneumococcus and, after clearance of their natural carriage episode, challenged them with a heterologous 6B strain. In another cohort of volunteers we assessed 6BPS-specific, PspA-specific, and PspC-specific IgG and IgA plasma and memory B-cell populations before and 7, 14, and 35 days after experimental pneumococcal inoculation. Measurements and Main Results: Heterologous challenge with 6B resulted in 50% carriage among volunteers with previous natural pneumococcal carriage. Protection from carriage was associated with a high number of circulating 6BPS IgG-secreting memory B cells at baseline. There were no associations between protection from carriage and baseline levels of 6BPS IgG in serum or nasal wash, PspA-specific, or PspC-specific memory B cells or plasma cells. In volunteers who did not develop carriage, the number of circulating 6BPS memory B cells decreased and the number of 6BPS plasma cells increased postinoculation. Conclusions: Our data indicate that naturally acquired PS-specific memory B cells, but not levels of circulating IgG at time of pneumococcal exposure, are associated with protection against carriage acquisition

Dexamethasone cyclophosphamide pulse therapy in pemphigus: experience in Kashmir valley.

Thirty patients of pemphigus have been treated with Dexamethasone Cyclophosphamide Pulse (DCP) in our hospital in the past three years. Of these twelve patients are off all treatment and are in complete remission while the rest are in different phases of the treatment and responding quite well to the pulse therapy. Only one case of relapse has been experienced till date.

Zinsser-Cole-Engmann syndrome.

Zinser-Cole-Engmann syndrome is a rare syndrome characterized by atrophy and pigmentation of skin, nail dystrophy and oral leukoplakia. Here we report a case of this rare entity.

Treatment of acute guttate psoriasis with rifampicin.

Sixty randomly selected patients of acute guttate psoriasis were put on oral rifampicin for a period of 10-15 days. Improvement in reference to clearing of lesions was studied. Complete improvement was noticed in 26 patients and in 10 patients partial improvement was noticed while in 12 patients no improvement was seen. The rest of the patients did not report for follow up.

Psychomotor retardation - an unusual association of keratosis follicularis spinulosa decalvans.

Keratosis follicularis spinulosa decalvans is one of a group of related disorders that shows keratosis pilaris with inflammation followed by atrophy. Here we report a case of this relatively rare disorder in a 6-year old boy who had associated psychomotor retardation.