Wunderlich syndrome as a rare complication of polyarteritis nodosa: a case report.

Spontaneous subcapsular and perirenal hemorrhage, known as Wunderlich syndrome (WS), is a rare clinical manifestation of polyarteritis nodosa (PAN). We report a case of a 48-year-old male with a history of recurrent episodes of leg muscle tenderness and dysesthesia, bilateral flank pain, painful nodular skin lesions in the lower limbs, weight loss, and difficult-to-control arterial hypertension. The abdominopelvic computed tomography angiography showed a large left perirenal hematoma, leading to the patient's admission to the intensive care unit. After the exclusion of infectious or neoplastic foci, the patient was diagnosed with PAN and started intravenous methylprednisolone pulses with a good response. Since WS is a rare initial clinical manifestation of PAN, an early diagnosis and aggressive treatment will significantly improve clinical outcomes.

Effect of extracorporeal shock wave therapy on pain and function in patients with knee osteoarthritis: a systematic review with meta-analysis and grade recommendations.

OBJECTIVE: To investigate extracorporeal shock wave therapy effect on knee osteoarthritis compared to a sham or kinesiotherapy by a systematic review and meta-analysis of randomized clinical trials. DATA SOURCES: The search was performed in: Cochrane Library, PubMed, PEDro, Web of Science, EMBASE, Scopus, LILACS, and Scielo. REVIEW METHODS: We performed the online search until October, 2022. The following terms were used (Osteoarthritis) AND ("knee joint") AND ("Extracorporeal Shockwave Therapy"). Eligibility criteria: (1) randomized clinical trials; (2) effects comparison of shockwave therapy to a sham or kinesiotherapy in individuals with knee osteoarthritis; (3) pain and physical function as outcome variables. Risk of bias assessed using the PEDro scale. PROSPERO registration (CRD42021235597). RESULTS: We identified 4217 studies, and 12 were included in the qualitative synthesis and the meta-analysis, totaling 403 individuals submitted to the intervention and 331 control individuals. Compared to sham, shockwave was favored in short-term for the function outcome (SMD = -1.93; 95%CI: [-2.77; -1.09]; I² = 83%; P < 0.01). For the pain outcome, the shockwave was favored in the short (MD = -2.05; 95%CI: [-2.59; -1.51]; I² = 84%; P < 0.01), medium (MD = -3.46; 95%CI: [-4.03; -2.89]; I² = 0%; P < 0.01) and long-term (MD = -2.01; 95%CI: [-3.36; -0.65]; I² = 98%; P < 0.01). The association with kinesiotherapy was favored in the short term for the function outcome (SMD = -1.88; 95%CI: [-2.98; -0.78]; I² = 94%; P < 0.01) and favored for the pain outcome in the short (MD = -1.44; 95%CI: [-1.81; -1.07]; I² = 37%; P = 0.14), medium (MD = -1,31; 95%CI: [-1.76; -0,85]; I² = 0%; P = 0.41), and long terms (MD = -1.63; 95%CI: [-1.73; -1.52]; I² = 0%; P = 0.43). CONCLUSION: Shockwave therapy may improve functionality in patients with knee osteoarthritis in the short term and pain in all follow-up moments, compared with sham. When associated to kinesiotherapy, it may improve function in the short term and pain in all follow-up time points, although improvement in pain may not be clinically significant.

Day hospital program for anorexia nervosa in children and adolescents: Assessment, management and specific focus on early onset anorexia nervosa.

INTRODUCTION: The French day hospital program specialized in eating disorders (ED) opened in January 2018. Our study presents preliminary data on clinical profiles of patients with anorexia nervosa (AN). We describe more specifically clinical characteristics of patients with early onset AN and according to their therapeutics orientations. Then, we compare the weight gain of patients managed only in day-patient (DP) treatment with those managed initially inpatient (IP) treatment and relays in DP. METHODS: Ninety-two patients with AN, aged between 8 and 18 years, were evaluated with several questionnaires (EDI-2, EDE-Q, BSQ, EDS-R, CDI, STAI-Y, VSP-A, EPN-13). RESULTS: Patients with early onset AN, n = 23 (25.3%), presented more restrictive behaviors, less marked dietary symptomatology, a lower degree of clinical perfectionism and a less marked feeling of ineffectiveness than adolescent patients with AN. Regarding the choice of hospitalization modality (DP alone or IP-DP), the only difference highlighted was the severity of patient undernutrition. Among the patients who were treated (IP-DP n = 27 vs DP alone n = 25), the weight evolution after one month and at discharge was favorable for both groups. CONCLUSION: These preliminary data suggest the effectiveness of DP in the care of AN in children and adolescents.

Demographic, clinical, and service-use characteristics related to the clinician's recommendation to transition from child to adult mental health services.

PURPOSE: The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians' advice to continue treatment at AMHS. METHODS: Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians' transition recommendations. RESULTS: Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. CONCLUSION: Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services.

[Improvement of the impulsive control in adolescents with attention deficit hyperactivity disorder (ADHD) after a cognitive behavioral therapy]. / Amélioration du contrôle impulsif chez les adolescents avec un trouble de l'attention avec hyperactivité (TDAH) ayant suivi une thérapie cognitive comportementale.

AIM: MPH is the more often prescribed stimulant for Attention Deficit Hyperactivity Disorder (ADHD), but it has been estimated that 30% of patients do not adequately respond or cannot tolerate it. Therefore, some other therapies are needed, such as cognitive behavioral therapy. Cognitive behavioral therapy is an intervention proposed over several sessions and aimed at modifying behavior by teaching different techniques that participants can re-use to control their symptoms. In our Institute, we used a program centered on attentional and metacognitive functions. It consists of a series of workshops performed in group at the rate of one workshop of 90minutes per week for 12 weeks. Positive effects on the behavior of adolescents with ADHD have been reported by parents and educators, but the effects of the program on specific cognitive processes have never been precisely investigated. METHOD: In the present study, we evaluated the impact of the program on impulsive control in adolescents with ADHD who are known to present impaired impulsive control. Impulsive control is required each time there is a conflict between an inappropriate prepotent action and a goal-directed action. At an experimental level, impulsive control can be studied with conflict tasks, such as the Simon reaction time task. Interpreted within the theoretical framework of the so-called « Dual-process activation suppression ¼ (DPAS) model, this task is a powerful conceptual and experimental tool to separately investigate the activation and inhibition of impulsive actions, which is almost never done in studies about impulsive control. Twenty adolescents followed the program and were tested before and at the end of the program by using dynamic analyses of performance associated with DPAS model. RESULTS: The results have shown an improvement of the impulsive control after three months of cognitive behavioral therapy, and this improvement was due to both a decrease of the propensity to trigger impulsive actions and an improvement of inhibitory processes efficiency. CONCLUSION: This program could be a relevant alternative to the stimulant medication, more particularly when parents are reluctant with medication or when the adolescent suffers from important side effects.

[Use of virtual reality in eating disorders]. / Utilisation de la réalité virtuelle dans les troubles des conduites alimentaires.

Virtual reality is a new technology that can be used to model an environment with which an individual can interact using all five senses. It is notably used in psychiatry for anxiety disorders and addictions, and its use in eating disorders has been growing in recent years. Indeed, virtual reality offers interesting advantages, such as its ability to personalize any environment, which is also more secure and controllable. Recent studies show promising results in the understanding, evaluation, and therapeutic management of eating disorders. The use of avatars in anorexia nervosa allows for a correct assessment of the perceptual (body image distortion) and cognitive-affective (body dissatisfaction) components of the body image disorder in a similar way to conventional methods, but also for a better understanding of them. Moreover, avatars allow the development of innovative therapeutic protocols and are thus used in the context of exposure therapy. The new body swapping protocol, based on a multisensory illusion, offers particularly promising results in the reduction of body image disorder. For bulimia nervosa and binge eating disorder, virtual reality has made it possible to better characterize the triggering mechanisms of binge eating episodes through studies that have observed different responses to food-related environments and stimuli. At the therapeutic level, virtual reality cue exposure therapy has the most empirical support. Its aim is to reduce or eliminate the anxiety and craving felt by a patient in response to exposure to food or other food-related cues by preventing the patient from consuming food, and results show clear reductions in anxiety, craving and binge eating episodes. While all these results seem to indicate a bright future for virtual reality in eating disorders, further studies are needed to validate the positive impact of its use, but also its limitations. Notably, cyber sickness could alter the smooth running of virtual reality therapy sessions by causing nausea and disorientation. Moreover, it is important to verify that a therapeutic protocol does not lose its effectiveness when it is transposed into virtual reality. However, virtual reality seems to be a therapeutic tool that is better accepted by patients, and even better by adolescents, which is very interesting for eating disorders since adolescents are the most affected. Virtual reality could therefore help motivate patients to pursue treatment and reduce the dropout rate while offering good therapeutic results. Thus, studies conducted in recent years have shown that virtual reality is a promising tool in the understanding, assessment and treatment of eating disorders, and future research should confirm this, particularly in the adolescent population.

Effect of dietary crude protein degradability and corn processing on lactation performance and milk protein composition and stability.

The present study aimed to evaluate the effect of crude protein degradability and corn processing on lactation performance, milk protein composition, milk ethanol stability (MES), heat coagulation time (HCT) at 140°C, and the efficiency of N utilization for dairy cows. Twenty Holstein cows with an average of 162 ± 70 d in milk, 666 ± 7 kg of body weight, and 36 ± 7.8 kg/d of milk yield (MY) were distributed in a Latin square design with 5 contemporaneous balanced squares, 4 periods of 21 d, and 4 treatments (factorial arrangement 2 × 2). Treatment factor 1 was corn processing [ground (GC) or steam-flaked corn (SFC)] and factor 2 was crude protein (CP) degradability (high = 10.7% rumen-degradable protein and 5.1% rumen-undegradable protein; low = 9.5% rumen-degradable protein and 6.3% rumen-undegradable protein; dry matter basis). A significant interaction was observed between CP degradability and corn processing on dry matter intake (DMI). When cows were fed GC with low CP degradability, DMI increased by 1.24 kg/d compared with cows fed GC with high CP degradability; however, CP degradability did not change DMI when cows were fed SFC. Similar interactions were observed for MY, HCT, and lactose content. When cows were fed GC diets, high CP degradability reduced MY by 2.3 kg/d, as well as HCT and lactose content, compared with low CP degradability. However, no effect of CP degradability was observed on those variables when cows were fed SFC diets. The SFC diets increased dry matter and starch total-tract digestibility and reduced ß-casein (CN) content (% total milk protein) compared with GC diets. Cows fed low-CP degradability diets had higher glycosylated κ-CN content (% total κ-CN) and MES, as well as milk protein content, 3.5% fat-corrected milk, and efficiency of N for milk production, than cows fed high-CP degradability diets. Therefore, GC and high-CP degradability diets reduced milk production and protein stability. Overall, low CP degradability increased the efficiency of dietary N utilization and MES, probably due to changes in casein micelle composition, as CP degradability or corn processing did not change the milk concentration of ionic calcium. The GC diets increased ß-CN content, which could contribute to reducing HTC when cows were fed GC and high-CP degradability diets.

[Adolescent sleep disorders associated with school absenteeism: The child and adolescent psychiatrist is often crucial for effective management in sleep consultation]. / Troubles du sommeil de l'adolescent associés à un absentéisme scolaire : le pédopsychiatre est souvent déterminant pour une prise en charge efficace en consultation de somnologie.

INTRODUCTION: Adolescent sleep is characterized by a physiological delayed sleep phase disorder frequently exacerbated by the intensive use of information and communication technologies. The sleep restriction thus induced during schooling has consequences on the physical and psychological health of the adolescent. On the other hand, the sleep complaint may correspond to psychiatric disorders in the adolescent. Thus, when this complaint is associated with school absenteeism, the management of sleep alone is often insufficient. In order to understand the reason for this inefficiency, we wanted to better characterize the profile of these adolescents. METHOD: We have developed a somnological and psychiatric "screening kit" resulting in a management decision tree. This kit was tested in 2017 as part of joint consultations at the Lyon Sleep Center in adolescents who presented a complaint of sleepiness or insomnia associated with school absenteeism. RESULTS: These preliminary results on 11 patients show the predominance of a delayed sleep phase syndrome or an absence of sleep diagnosis associated in more than 90 % of cases with anxiety-depressive difficulties ranging from the mood depressive disorder to the school refusal behavior and underlying anxiety disorders. Somatization is also common. CONCLUSION: These first data seem to confirm the need for a child and adolescent psychiatric assessment to deal with the psychological difficulties of these adolescents in parallel with their sleep complaint so as to offer them the best chances of improvement, re-schooling and social insertion.

Gingival crevicular fluid levels of human beta-defensin 1 in individuals with and without chronic periodontitis.

BACKGROUND AND OBJECTIVE: Human beta-defensins (hBDs) contribute to innate immunity antimicrobial activity. They are also effective in the adaptive immune response and may play a crucial role in the susceptibility to diseases of the oral cavity. This study aimed to evaluate the levels of hBD-1 in the gingival crevicular fluid of individuals with and without chronic periodontitis. MATERIAL AND METHODS: Twenty periodontally healthy individuals (H) and 20 individuals with chronic periodontitis were recruited. Gingival crevicular fluid samples were collected from: healthy sites (Hh) from periodontally healthy individuals; and healthy sites (Ph), sites with gingivitis (Pg), and sites with periodontitis (Pp) from individuals with periodontitis. The levels of hBD-1 (pg/mL) were measured using enzyme-linked immunosorbent assay. Comparisons of hBD-1 between individuals (H and chronic periodontitis) and among sites (Hh, Ph, Pg, Pp) were performed through hierarchical linear modeling. RESULTS: Gingival crevicular fluid levels of hBD-1 were: Hh = 229.52 ± 138.96 (median 199.26), Ph = 53.88 ± 58.17 (median 35.75), Pg = 57.11 ± 40.18 (median 39.90) and Pp = 55.31 ± 37.28 (median 54.19). No influence of site diagnosis (level 1; health/gingivitis/periodontitis) was observed; however, individual diagnosis (level 2; health/periodontitis) influenced the levels of hBD-1 (P < .001). CONCLUSION: Periodontally healthy individuals showed higher gingival crevicular fluid levels of hBD-1 when compared to individuals with chronic periodontitis. This suggests a potential protective role of hBD-1 in the susceptibility to chronic periodontitis.

[The schizophrenic's chilhood]. / Enfance du schizophrène.

Pathology of adolescence and young adult, schizophrenia can begin in very rare cases during childhood. Two early clinical forms of the disorder have been identified by epidemiological studies: one beginning at the age of 15; the other around 9 years old; While many questions remain unsanswered about the neurobiological and environmental factors - common or distinct - of these two clinical phenotype, both are related to a profoun and lasting alteration of the neurocognitive development whose origin would clearly go back to infancy or to the antenal period. Here we will present a possible story back of schizophrenia in the light of the latest neuroscientific studies in imagery and genetics from adolescence to antenal period.

[Very early onset schizophrenia]. / Schizophrénie à début très précoce.

Very early onset schizophrenia begins before the age of 13. This form of schizophrenia is particularly difficult to diagnose. The differential diagnosis is difficult because some psychotic signs can be passing or be representative of an anxious or depressive disorder. The differential diagnosis with the autistic spectrum disorder is also complex. Finally, other disorders are associated in the majority of the cases. It is a neurodevelopmental disorder with premature cerebral anomalies engendered by the interaction of genetic factors and environmental factors. There seems be a real continuity between the very early form and the adult form although very early onset schizophrenia is a severe form of the disorder which carries a relatively poor prognosis. Its outcome depends both on early screening, the quality of diagnosis and on the speed of multidisciplinary interventions offered.

[Contribution of mindfulness meditation in cognitive behavioral therapy for insomnia]. / Apport de la pleine conscience dans les thérapies cognitives et comportementales de l'insomnie.

INTRODUCTION: Insomnia is considered to be a serious public health issue affecting approximately 10% of adults. Chronic insomnia may increase the risk of health problem, psychological vulnerability and proneness to accidents. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first line of treatment. Even though CBT-I is widely considered as an effective therapy, 20 to 30% of patients do not respond to this treatment. Mindfulness therapy, known to reduce rumination and stress, could be an interesting complement to enhance CBT-I. The aim of this study is to evaluate the efficacy of therapy combining mindfulness meditation and CBT-I for the treatment of chronic insomnia. METHODS: Thirty-three patients, diagnosed with chronic insomnia, aged 18 to 75 years (51±15 years) were recruited between October 2015 and June 2016 at the Sleep Center of Marseille. The patients were then divided into two groups according to their psychotherapy method: group CBT-I alone (17 patients) or a group therapy combining CBT-I and Mindfulness (16 patients). All participants were given five sessions of standard CBT during eight weeks. The patient-reported outcome measures were sleep onset latency, wake after sleep onset (WASO), total wake time, total sleep time, time in bed, sleep efficiency and number of awakening from sleep diaries before treatment (T0) and six weeks later (T1). Assessments were done using Pittsburgh Sleep quality index (PSQI), Insomnia severity Index (ISI), the Epworth sleepiness scale, the hospital anxiety and depression scale (HAD), the dysfunctional beliefs and attitude about sleep (DBAS-16); further, the use of sleeping pills was also recorded at T0 and T1. RESULTS: Out of the 33 participants who began the treatment, 29 completed all sessions and were included in the analyses (4 dropouts in the group CBT-I alone). The data shows that each treatment yielded significant improvements over time in sleep variables from the diary, PSQI, ISI, anxiety (P=0.004), DBAS 16, sleeping pill use and vitality measured by SF36 health survey (P=0.004). Comparing the results of the two therapy groups, the meditation associated to CBT-I shows significantly greater rates of reduction in WASO relative to CBT-I group (P=0.009). CONCLUSIONS: This study confirms the beneficial effects of CBT for patients suffering from insomnia on sleep parameters, anxiety symptoms and quality of life. Furthermore, this study suggests, for the first time, that combining CBT and mindfulness is a superior approach compared to that of only conventional CBT-I in improving sleep.

Dog skin parasite load, TLR-2, IL-10 and TNF-α expression and infectiousness.

Visceral leishmaniosis is a zoonotic disease that is transmitted by Lutzomyia longipalpis sandflies. Dogs are the main peri-urban reservoir of the disease, and progression of canine leishmaniosis is dependent on the type of immune response elaborated against the parasite. Type 1 immunity is characterized by effective cellular response, with production of pro-inflammatory cytokines such as tumour necrosis factor alpha (TNF-α). In contrast, Type 2 immunity is predominantly humoral, associated with progression of the disease and mediated by anti-inflammatory cytokines such as interleukin 10 (IL-10). Although seemly important in the dynamics of leishmaniosis, other gene products such as toll-like receptor 2 (TRL-2) and inducible nitric oxide synthase (iNOS) exert unclear roles in the determination of the type of immune response. Given that the dog skin serves as a micro-environment for the multiplication of Leishmania spp., we investigated the parasite load and the expression of TLR-2, iNOS, IL-10 and TNF-α in the skin of 29 infected and 8 control dogs. We found that increased parasite load leads to upregulation of TLR-2, IL-10 and TNF-α, indicating that abundance of these transcripts is associated with infection. We also performed a xenodiagnosis to demonstrate that increased parasitism is a risk factor for infectiousness to sandflies.

[Recognition of facial expressions of emotions by 3-year-olds depending on sleep and risk of depression]. / Reconnaissance émotionnelle chez les enfants de 3ans en fonction du sommeil et du risque de dépression.

INTRODUCTION: The emotional process is characterized by a negative bias in depression, thus it was legitimate to establish if they same is true in very young at-risk children. Furthermore, sleep, also proposed as a marker of the depression risk, is closely linked in adults and adolescents with emotions. That is why we wanted first to better describe the characteristics of emotional recognition by 3-year-olds and their links with sleep. Secondly we observed, if found at this young age, an emotional recognition pattern indicating a vulnerability to depression. MATERIAL AND METHOD: We studied, in 133 children aged 36 months from the AuBE cohort, the number of correct answers to the task of recognition of facial emotions (joy, anger and sadness). Cognitive functions were also assessed by the WPPSI III at 3 years old, and the different sleep parameters (time of light off and light on, sleep times, difficulty to go to sleep and number of parents' awakes per night) were described by questionnaires filled out by mothers at 6, 12, 18, 24 and 36 months after birth. Of these 133 children, 21 children whose mothers had at least one history of depression (13 boys) were the high-risk group and 19 children (8 boys) born to women with no history of depression were the low-risk group (or control group). RESULTS: Overall, 133 children by the age of 36 months recognize significantly better happiness than other emotions (P=0.000) with a better global recognition higher in girls (M=8.8) than boys (M=7.8) (P=0.013) and a positive correlation between global recognition ability and verbal IQ (P=0.000). Children who have less daytime sleep at 18 months and those who sleep less at 24 months show a better recognition of sadness (P=0.043 and P=0.042); those with difficulties at bedtime at 18 months recognize less happiness (P=0.043), and those who awaken earlier at 24 months have a better global recognition of emotions (P=0.015). Finally, the boys of the high-risk group recognize sadness better than boys in the control group (P=0.015). CONCLUSION: This study confirms that the recognition of emotion is related to development with a female advantage and a link with the language skills at 36 months of life. More importantly, we found a relationship between sleep characteristics and emotional recognition ability and a negative bias in emotional recognition in young males at risk for depression.

[Noninvasive cerebral stimulation for treatment of ADHD: A review of the literature]. / Stimulation cérébrale non invasive dans le traitement du trouble déficit de l'attention avec ou sans hyperactivité : une revue de la littérature.

OBJECTIVES: The aim of this review is to summarize the available data in the literature about the therapeutic applications of transcranial magnetic stimulation and transcranial direct current stimulation in attention-deficit hyperactivity disorder (ADHD). METHOD: The scientific literature search of international articles was performed in February 2016 using the PubMed electronic database. The following MeSH terms were employed: "attention-deficit disorder with hyperactivity" AND "transcranial magnetic stimulation", "attention-deficit disorder with hyperactivity" AND "transcranial direct current stimulation". RESULTS: Five studies were retained by the literature search and were included in the review about rTMS and ADHD. Except for one study, they all showed significant positive effects of rTMS on ADHD. Four studies were retained by the literature search and were included in the review about tDCS and ADHD. Three of them showed significant positive effects of tDCS on ADHD. Two of them used tDCS during sleep at a frequency<1Hz. Only low-level evidences are available to support treatment with rTMS or tDCS in patients with ADHD. Indeed, randomized controlled trials are rare in this field of research. CONCLUSION: Additional studies are needed to confirm the efficacy of rTMS and tDCS in ADHD. rTMS could be used as an alternative therapy when methylphenidate is not well tolerated or shows an insufficient efficacy. Nevertheless, the optimal target, frequency and duration remain to be determined. tDCS can modulate attention in healthy subjects but data are insufficient in ADHD to conclude. It could be interesting to study its use in association with cognitive remediation to enhance its cognitive efficacy.

Requirement of MyD88 and Fas pathways for the efficacy of allergen-free immunotherapy.

BACKGROUND: We have shown that mycobacterial antigens and CpG oligodeoxynucleotides downmodulate airway allergic inflammation by mechanisms dependent on T-cell activation. Here, we investigated the participation of the innate response, particularly the role of MyD88 adaptor, and Fas molecules in the effectiveness of DNA-HSP65 or CpG/culture filtrated proteins (CFP) immunotherapy. METHODS: Mice sensitized and challenged with Der p 1 allergen were treated with DNA-HSP65, CpG/CFP, or with adoptively transferred cells from immunized mice. The treatment efficacy was assessed by evaluating eosinophil recruitment, antibody, and cytokine production. RESULTS: In addition to downregulating the Th2 response, DNA-HSP65 and CpG/CFP promoted IL-10 and IFN-γ production. Adoptive transfer of cells from mice immunized with DNA-HSP65 or CpG/CFP to allergic recipients downmodulated the allergic response. Notably, transfer of cells from DNA-HSP65- or CpG/CFP-immunized MyD88(-/-) mice failed to reduce allergy. Additionally, for effective reduction of allergy by cells from CpG/CFP-immunized mice, Fas molecules were required. Although DNA-HSP65 or CpG/CFP immunization stimulated antigen-specific production of IFN-γ and IL-10, the effect of DNA-HSP65 was associated with IL-10 while CpG/CFP was associated with IFN-γ. Moreover, after stimulation with mycobacterial antigens plus Der p 1 allergen, cells from mite-allergic patients with asthma exhibited similar patterns of cytokine production as those found in the lung of treated mice. CONCLUSIONS: This study provides new insights on the mechanisms of allergen-free immunotherapy by showing that both DNA-HSP65 and CpG/CFP downregulated house dust mite-induced allergic airway inflammation via distinct pathways that involve not only induction of mycobacterial-specific adaptive responses but also signaling via MyD88 and Fas molecules.

Density-Dependent Oviposition by Female Aedes albopictus (Diptera: Culicidae) Spreads Eggs Among Containers During the Summer but Accumulates Them in the Fall.

When possible, oviparous females should deposit eggs in sites that maximize the future performance of their offspring. Therefore, studies of oviposition behavior may uncover parameters important to offspring fitness. Gravid female Aedes albopictus (Skuse) were given a choice of containers with leaf infusion or plain water, either open or with a cover with a small opening, and their behavior was compared under summer (long day, higher temperature) or fall (short day, lower temperature) regimes. Open containers with leaf infusion were always preferred, but over time, summer females expanded their choices to oviposit in all containers and follow-up experiments indicated that the number of eggs laid was inversely correlated to the number of eggs present. In contrast, fall females laying diapausing eggs that do not hatch until the spring, accumulated eggs in open containers with food resulting in high egg densities. Combined, these results demonstrate a seasonal shift that suggests either high winter egg mortality or safety in numbers. It also demonstrates that female Ae. albopictus change their behavior based on cues associated with expected added risk, which varies across time and space. The wide distribution of summer eggs across container types may contribute to the fast expansion of Ae. albopictus across its invasive range, but egg accumulation in the fall may be exploited for control.

A novel TGM1 mutation, leading to multiple splicing rearrangements, is associated with autosomal recessive congenital ichthyosis.

Autosomal recessive congenital ichthyosis (ARCI) is a group of rare, clinically heterogeneous skin disorders that affect cornification. ARCI includes lamellar ichthyosis, congenital ichthyosiform erythroderma and harlequin ichthyosis. TGM1 mutations cause > 50% of ARCI cases in the USA. We report two siblings with ARCI. They were found to carry a novel aetiological TGM1 mutation, which leads to the synthesis of multiple abnormal transcripts. These molecules resulted from three independent mechanisms: intron retention, exon skipping and activation of expand cryptic splice sites. Taken together, our findings expand the known TGM1 mutation repertoire, and provide an insight into the molecular mechanisms leading to ARCI phenotypes. These results could be useful for genetic counselling and future potential genotype-phenotype correlations.