RESUMEN
How lipidome changes support CD8+ effector T (Teff) cell differentiation is not well understood. Here we show that, although naive T cells are rich in polyunsaturated phosphoinositides (PIPn with 3-4 double bonds), Teff cells have unique PIPn marked by saturated fatty acyl chains (0-2 double bonds). PIPn are precursors for second messengers. Polyunsaturated phosphatidylinositol bisphosphate (PIP2) exclusively supported signaling immediately upon T cell antigen receptor activation. In late Teff cells, activity of phospholipase C-γ1, the enzyme that cleaves PIP2 into downstream mediators, waned, and saturated PIPn became essential for sustained signaling. Saturated PIP was more rapidly converted to PIP2 with subsequent recruitment of phospholipase C-γ1, and loss of saturated PIPn impaired Teff cell fitness and function, even in cells with abundant polyunsaturated PIPn. Glucose was the substrate for de novo PIPn synthesis, and was rapidly utilized for saturated PIP2 generation. Thus, separate PIPn pools with distinct acyl chain compositions and metabolic dependencies drive important signaling events to initiate and then sustain effector function during CD8+ T cell differentiation.
Asunto(s)
Fosfatos de Fosfatidilinositol , Fosfatidilinositoles , Fosfatidilinositoles/metabolismo , Transducción de Señal , Fosfolipasas de Tipo C/metabolismo , Linfocitos T CD8-positivos/metabolismoRESUMEN
T cell receptor (TCR) signaling without CD28 can elicit primary effector T cells, but memory T cells generated during this process are anergic, failing to respond to secondary antigen exposure. We show that, upon T cell activation, CD28 transiently promotes expression of carnitine palmitoyltransferase 1a (Cpt1a), an enzyme that facilitates mitochondrial fatty acid oxidation (FAO), before the first cell division, coinciding with mitochondrial elongation and enhanced spare respiratory capacity (SRC). microRNA-33 (miR33), a target of thioredoxin-interacting protein (TXNIP), attenuates Cpt1a expression in the absence of CD28, resulting in cells that thereafter are metabolically compromised during reactivation or periods of increased bioenergetic demand. Early CD28-dependent mitochondrial engagement is needed for T cells to remodel cristae, develop SRC, and rapidly produce cytokines upon restimulation-cardinal features of protective memory T cells. Our data show that initial CD28 signals during T cell activation prime mitochondria with latent metabolic capacity that is essential for future T cell responses.
Asunto(s)
Antígenos CD28/metabolismo , Activación de Linfocitos , Mitocondrias/metabolismo , Linfocitos T/citología , Linfocitos T/inmunología , Animales , Carnitina O-Palmitoiltransferasa , Inhibidores Enzimáticos/farmacología , Compuestos Epoxi/farmacología , Humanos , Interleucina-15/inmunología , Ratones , Ratones Endogámicos C57BL , Receptores de Antígenos de Linfocitos T/metabolismo , Estrés Fisiológico , Linfocitos T/metabolismoRESUMEN
Activated effector T (TE) cells augment anabolic pathways of metabolism, such as aerobic glycolysis, while memory T (TM) cells engage catabolic pathways, like fatty acid oxidation (FAO). However, signals that drive these differences remain unclear. Mitochondria are metabolic organelles that actively transform their ultrastructure. Therefore, we questioned whether mitochondrial dynamics controls T cell metabolism. We show that TE cells have punctate mitochondria, while TM cells maintain fused networks. The fusion protein Opa1 is required for TM, but not TE cells after infection, and enforcing fusion in TE cells imposes TM cell characteristics and enhances antitumor function. Our data suggest that, by altering cristae morphology, fusion in TM cells configures electron transport chain (ETC) complex associations favoring oxidative phosphorylation (OXPHOS) and FAO, while fission in TE cells leads to cristae expansion, reducing ETC efficiency and promoting aerobic glycolysis. Thus, mitochondrial remodeling is a signaling mechanism that instructs T cell metabolic programming.
Asunto(s)
Dinámicas Mitocondriales , Linfocitos T/citología , Linfocitos T/metabolismo , Animales , Diferenciación Celular , Transporte de Electrón , Ácidos Grasos/metabolismo , GTP Fosfohidrolasas/metabolismo , Glucólisis , Humanos , Memoria Inmunológica , Ratones , Ratones Endogámicos C57BL , Oxidación-Reducción , Transducción de Señal , Linfocitos T/inmunologíaRESUMEN
Failure of T cells to protect against cancer is thought to result from lack of antigen recognition, chronic activation, and/or suppression by other cells. Using a mouse sarcoma model, we show that glucose consumption by tumors metabolically restricts T cells, leading to their dampened mTOR activity, glycolytic capacity, and IFN-γ production, thereby allowing tumor progression. We show that enhancing glycolysis in an antigenic "regressor" tumor is sufficient to override the protective ability of T cells to control tumor growth. We also show that checkpoint blockade antibodies against CTLA-4, PD-1, and PD-L1, which are used clinically, restore glucose in tumor microenvironment, permitting T cell glycolysis and IFN-γ production. Furthermore, we found that blocking PD-L1 directly on tumors dampens glycolysis by inhibiting mTOR activity and decreasing expression of glycolysis enzymes, reflecting a role for PD-L1 in tumor glucose utilization. Our results establish that tumor-imposed metabolic restrictions can mediate T cell hyporesponsiveness during cancer.
Asunto(s)
Linfocitos T CD8-positivos/metabolismo , Glucólisis , Linfocitos Infiltrantes de Tumor/metabolismo , Neoplasias/metabolismo , Microambiente Tumoral , Animales , Anticuerpos Monoclonales/administración & dosificación , Antígeno B7-H1/antagonistas & inhibidores , Antígeno B7-H1/inmunología , Linfocitos T CD8-positivos/inmunología , Antígeno CTLA-4/antagonistas & inhibidores , Antígeno CTLA-4/inmunología , Interferón gamma/inmunología , Linfocitos Infiltrantes de Tumor/inmunología , Ratones , Neoplasias/inmunología , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Receptor de Muerte Celular Programada 1/inmunologíaRESUMEN
A "switch" from oxidative phosphorylation (OXPHOS) to aerobic glycolysis is a hallmark of T cell activation and is thought to be required to meet the metabolic demands of proliferation. However, why proliferating cells adopt this less efficient metabolism, especially in an oxygen-replete environment, remains incompletely understood. We show here that aerobic glycolysis is specifically required for effector function in T cells but that this pathway is not necessary for proliferation or survival. When activated T cells are provided with costimulation and growth factors but are blocked from engaging glycolysis, their ability to produce IFN-γ is markedly compromised. This defect is translational and is regulated by the binding of the glycolysis enzyme GAPDH to AU-rich elements within the 3' UTR of IFN-γ mRNA. GAPDH, by engaging/disengaging glycolysis and through fluctuations in its expression, controls effector cytokine production. Thus, aerobic glycolysis is a metabolically regulated signaling mechanism needed to control cellular function.
Asunto(s)
Glucólisis , Activación de Linfocitos , Fosforilación Oxidativa , Linfocitos T/citología , Linfocitos T/metabolismo , Regiones no Traducidas 3' , Animales , Proliferación Celular , Gliceraldehído-3-Fosfato Deshidrogenasas/metabolismo , Interferón gamma/genética , Listeria monocytogenes , Listeriosis/inmunología , Ratones , Ratones Endogámicos C57BL , Biosíntesis de Proteínas , Linfocitos T/inmunologíaRESUMEN
CD4+ T cell differentiation requires metabolic reprogramming to fulfil the bioenergetic demands of proliferation and effector function, and enforce specific transcriptional programmes1-3. Mitochondrial membrane dynamics sustains mitochondrial processes4, including respiration and tricarboxylic acid (TCA) cycle metabolism5, but whether mitochondrial membrane remodelling orchestrates CD4+ T cell differentiation remains unclear. Here we show that unlike other CD4+ T cell subsets, T helper 17 (TH17) cells have fused mitochondria with tight cristae. T cell-specific deletion of optic atrophy 1 (OPA1), which regulates inner mitochondrial membrane fusion and cristae morphology6, revealed that TH17 cells require OPA1 for its control of the TCA cycle, rather than respiration. OPA1 deletion amplifies glutamine oxidation, leading to impaired NADH/NAD+ balance and accumulation of TCA cycle metabolites and 2-hydroxyglutarate-a metabolite that influences the epigenetic landscape5,7. Our multi-omics approach revealed that the serine/threonine kinase liver-associated kinase B1 (LKB1) couples mitochondrial function to cytokine expression in TH17 cells by regulating TCA cycle metabolism and transcriptional remodelling. Mitochondrial membrane disruption activates LKB1, which restrains IL-17 expression. LKB1 deletion restores IL-17 expression in TH17 cells with disrupted mitochondrial membranes, rectifying aberrant TCA cycle glutamine flux, balancing NADH/NAD+ and preventing 2-hydroxyglutarate production from the promiscuous activity of the serine biosynthesis enzyme phosphoglycerate dehydrogenase (PHGDH). These findings identify OPA1 as a major determinant of TH17 cell function, and uncover LKB1 as a sensor linking mitochondrial cues to effector programmes in TH17 cells.
Asunto(s)
Proteínas Quinasas Activadas por AMP , Mitocondrias , Células Th17 , Glutamina/metabolismo , Interleucina-17/metabolismo , Mitocondrias/metabolismo , NAD/metabolismo , Fosfoglicerato-Deshidrogenasa/metabolismo , Serina/biosíntesis , Serina/metabolismo , Células Th17/citología , Células Th17/inmunología , Células Th17/metabolismo , Proteínas Quinasas Activadas por AMP/metabolismo , Ciclo del Ácido Cítrico , GTP Fosfohidrolasas/deficiencia , GTP Fosfohidrolasas/genética , GTP Fosfohidrolasas/metabolismoRESUMEN
Metabolic engagement is intrinsic to immune cell function. Prostaglandin E2 (PGE2) has been shown to modulate macrophage activation, yet how PGE2 might affect metabolism is unclear. Here, we show that PGE2 caused mitochondrial membrane potential (Δψm) to dissipate in interleukin-4-activated (M(IL-4)) macrophages. Effects on Δψm were a consequence of PGE2-initiated transcriptional regulation of genes, particularly Got1, in the malate-aspartate shuttle (MAS). Reduced Δψm caused alterations in the expression of 126 voltage-regulated genes (VRGs), including those encoding resistin-like molecule α (RELMα), a key marker of M(IL-4) cells, and genes that regulate the cell cycle. The transcription factor ETS variant 1 (ETV1) played a role in the regulation of 38% of the VRGs. These results reveal ETV1 as a Δψm-sensitive transcription factor and Δψm as a mediator of mitochondrial-directed nuclear gene expression.
Asunto(s)
Núcleo Celular/efectos de los fármacos , Dinoprostona/farmacología , Regulación de la Expresión Génica/efectos de los fármacos , Macrófagos/efectos de los fármacos , Potencial de la Membrana Mitocondrial/fisiología , Animales , Núcleo Celular/genética , Células Cultivadas , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Perfilación de la Expresión Génica , Células HEK293 , Humanos , Interleucina-4/farmacología , Activación de Macrófagos/efectos de los fármacos , Activación de Macrófagos/genética , Macrófagos/metabolismo , Macrófagos/ultraestructura , Ratones , Ratones Endogámicos C57BL , Células 3T3 NIH , Transducción de Señal/efectos de los fármacos , Transducción de Señal/genética , Factores de Transcripción/genética , Factores de Transcripción/metabolismoRESUMEN
Alternative (M2) activation of macrophages driven via the α-chain of the receptor for interleukin 4 (IL-4Rα) is important for immunity to parasites, wound healing, the prevention of atherosclerosis and metabolic homeostasis. M2 polarization is dependent on fatty acid oxidation (FAO), but the source of the fatty acids that support this metabolic program has not been clear. We found that the uptake of triacylglycerol substrates via the scavenger receptor CD36 and their subsequent lipolysis by lysosomal acid lipase (LAL) was important for the engagement of elevated oxidative phosphorylation, enhanced spare respiratory capacity (SRC), prolonged survival and expression of genes that together define M2 activation. Inhibition of lipolysis suppressed M2 activation during infection with a parasitic helminth and blocked protective responses to this pathogen. Our findings delineate a critical role for cell-intrinsic lysosomal lipolysis in M2 activation.
Asunto(s)
Antígenos CD36/inmunología , Ácidos Grasos/metabolismo , Interleucina-4/inmunología , Lipólisis/inmunología , Lisosomas/inmunología , Activación de Macrófagos/inmunología , Macrófagos/inmunología , Fosforilación Oxidativa , Transducción de Señal/inmunología , Esterol Esterasa/inmunología , Animales , Respiración de la Célula , Helmintiasis Animal/inmunología , Humanos , Ratones , Consumo de Oxígeno , Receptores de Interleucina-4/inmunología , TranscriptomaRESUMEN
T cell activation and proliferation critical for protective immunity depend on appropriate rewiring of cellular metabolism. In this issue of Immunity, Mak et al. (2017) show that the antioxidant gluthathione (GSH) controls reactive oxygen species (ROS)-dependent engagement of metabolic signaling pathways that lead to protective T cell responses.
Asunto(s)
Glutatión , Especies Reactivas de Oxígeno , Antioxidantes , Transducción de Señal , Linfocitos TRESUMEN
PURPOSE: Intra-Discal Vacuum phenomenon (IDVP) is well-recognised, yet poorly visualised and poorly understood radiological finding in disc degeneration, particularly with regard to its role in spinal alignment. CT analysis of the lumbar spine in an aging population aims to identify patterns associated with IDVP including lumbopelvic morphology and associated spinal diagnoses. METHODS: An analysis was performed of an over-60s population sample of 2020 unrelated abdominal CT scans, without acute spinal presentations. Spinal analysis included sagittal lumbopelvic reconstructions to assess for IDVP and pelvic incidence (PI). Subjects with degenerative pathologies, including previous vertebral fractures, auto-fusion, transitional vertebrae, and listhesis, were also selected out and analysed separately. RESULTS: The prevalence of lumbar spine IDVP was 50.3% (955/1898) and increased with age (125 exclusions). This increased in severity towards the lumbosacral junction (L1L2 8.3%, L2L3 10.9%, L3L4 11.5%, L4L5 23.9%, and L5S1 46.3%). A lower PI yielded a higher incidence of IDVP, particularly at L5S1 (p < 0.01). A total of 292 patients had IDVP with additional degenerative pathologies, which were more likely to occur at the level of isthmic spondylolisthesis, adjacent to a previous fracture or suprajacent to a lumbosacral transitional vertebra (p < 0.05). CONCLUSIONS: This study identified the prevalence and severity of IDVP in an aging population. Sagittal patterns that influence the pattern of IVDP, such as pelvic incidence and degenerative pathologies, provide novel insights into the function of aging spines.
Asunto(s)
Degeneración del Disco Intervertebral , Vértebras Lumbares , Humanos , Vértebras Lumbares/diagnóstico por imagen , Anciano , Masculino , Femenino , Degeneración del Disco Intervertebral/epidemiología , Degeneración del Disco Intervertebral/diagnóstico por imagen , Persona de Mediana Edad , Anciano de 80 o más Años , Envejecimiento/patología , Envejecimiento/fisiología , Vacio , Tomografía Computarizada por Rayos X , PrevalenciaRESUMEN
Fever can provide a survival advantage during infection. Metabolic processes are sensitive to environmental conditions, but the effect of fever on T cell metabolism is not well characterized. We show that in activated CD8+ T cells, exposure to febrile temperature (39 °C) augmented metabolic activity and T cell effector functions, despite having a limited effect on proliferation or activation marker expression. Transcriptional profiling revealed an up-regulation of mitochondrial pathways, which was consistent with increased mass and metabolism observed in T cells exposed to 39 °C. Through in vitro and in vivo models, we determined that mitochondrial translation is integral to the enhanced metabolic activity and function of CD8+ T cells exposed to febrile temperature. Transiently exposing donor lymphocytes to 39 °C prior to infusion in a myeloid leukemia mouse model conferred enhanced therapeutic efficacy, raising the possibility that exposure of T cells to febrile temperatures could have clinical potential.
Asunto(s)
Linfocitos T CD8-positivos/inmunología , Fiebre/inmunología , Mitocondrias/metabolismo , Biosíntesis de Proteínas , Animales , Antineoplásicos/metabolismo , Linfocitos T CD8-positivos/ultraestructura , Citocinas/biosíntesis , Glucosa/metabolismo , Leucemia Mieloide/inmunología , Leucemia Mieloide/patología , Leucemia Mieloide/prevención & control , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Mitocondrias/ultraestructura , Modelos Biológicos , TemperaturaRESUMEN
Generation of CD8(+) memory T cells requires metabolic reprogramming that is characterized by enhanced mitochondrial fatty-acid oxidation (FAO). However, where the fatty acids (FA) that fuel this process come from remains unclear. While CD8(+) memory T cells engage FAO to a greater extent, we found that they acquired substantially fewer long-chain FA from their external environment than CD8(+) effector T (Teff) cells. Rather than using extracellular FA directly, memory T cells used extracellular glucose to support FAO and oxidative phosphorylation (OXPHOS), suggesting that lipids must be synthesized to generate the substrates needed for FAO. We have demonstrated that memory T cells rely on cell intrinsic expression of the lysosomal hydrolase LAL (lysosomal acid lipase) to mobilize FA for FAO and memory T cell development. Our observations link LAL to metabolic reprogramming in lymphocytes and show that cell intrinsic lipolysis is deterministic for memory T cell fate.
Asunto(s)
Linfocitos T CD8-positivos/inmunología , Ácidos Grasos/metabolismo , Memoria Inmunológica/inmunología , Lipólisis/inmunología , Esterol Esterasa/metabolismo , 4-Butirolactona/análogos & derivados , 4-Butirolactona/farmacología , Traslado Adoptivo , Animales , Linfocitos T CD8-positivos/metabolismo , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Ácido Graso Sintasas/antagonistas & inhibidores , Ácido Graso Sintasas/genética , Ácidos Grasos/biosíntesis , Glucosa/metabolismo , Interleucina-15/inmunología , Interleucina-2/inmunología , Lipólisis/genética , Activación de Linfocitos/inmunología , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Mitocondrias/metabolismo , Oxidación-Reducción , Fosforilación Oxidativa , Oxígeno/metabolismo , Proteínas Quinasas/genética , Interferencia de ARN , ARN Interferente Pequeño , Esterol Esterasa/biosíntesisRESUMEN
Gene drives offer a potentially revolutionary method for pest control over large spatial extents. These genetic modifications spread deleterious variants through a population and have been proposed as methods for pest suppression or even eradication. We examined the influence of local dispersal, long-distance and/or human-mediated dispersal, and variation in population growth on the success of a gene drive for the control of invasive social wasps (Vespula vulgaris). Our simulations incorporated a spatially realistic environment containing variable habitat quality in New Zealand. Pest eradication was not observed, except in extreme and unrealistic scenarios of constant, widespread, and spatially intense releases of genetically modified individuals every year for decades. Instead, the regional persistence of genetically modified and wild-type wasps was predicted. Simulations using spatially homogeneous versus realistic landscapes (incorporating uninhabitable areas and dispersal barriers) showed little difference in overall population dynamics. Overall, little impact on wasp abundance was observed in the first 15 years after introduction. After 25 years, populations were suppressed to levels <95% of starting populations. Populations exhibited "chase dynamics" with population cycles in space, with local extinction occurring in some areas while wasps became abundant in others. Increasing the wasps' local dispersal distance increased the spatial and temporal variability of the occupied area and population suppression. Varying levels of human-associated long-distance dispersal had little effect on population dynamics. Increasing intrinsic population growth rates interacted with local dispersal to cause higher mean populations and substantially higher levels of variation in population suppression and the total amount of landscape occupied. Gene drives appear unlikely to cause a rapid and widespread extinction of this and probably other pests but could offer long-term and cost-effective methods of pest suppression. The predicted level of <95% pest suppression would substantially reduce the predation pressure and competitive interactions of this invasive wasp on native species. However, the predicted long-term persistence of genetically modified pests will influence the ethics and likelihood of using gene drives for pest control, especially given concerns that modified wasps would eventually be transported back to their home range.
Asunto(s)
Tecnología de Genética Dirigida , Mariposas Nocturnas , Avispas , Humanos , Animales , Avispas/genética , Dinámica Poblacional , EcosistemaRESUMEN
Microplastics are ubiquitous emerging contaminants found in every habitat surveyed, building upon international databases globally. Costs and accessibility often correlate to few deep sea sediment surveys, restricting the number of stations within a given sampling area. An extensive survey of the Porcupine Seabight, Porcupine Bank, the Goban Spur, and south-western canyons resulted in identifying microplastics in deep sea sediment surface layers from 33 of the 44 stations sampled (75%), with a total of 83 particles (74 synthetic and 9 natural) recorded. No microplastic hotspots were identified, and abundances (kg d.w.-1) were not correlated with distance from land, depth, or the presence of macrolitter on the seafloor. Understanding the sources of deep sea microplastics, such as marine traffic, is crucial to developing effective mitigation strategies as well as further monitoring campaigns targeting microplastic pollution in areas with significant deep sea biodiversity such as the Porcupine Seabright.
Asunto(s)
Microplásticos , Contaminantes Químicos del Agua , Plásticos , Contaminantes Químicos del Agua/análisis , Sedimentos Geológicos , Monitoreo del Ambiente/métodos , Océano AtlánticoRESUMEN
University-industry collaboration (UIC) projects are complex undertakings, that can involve multiple parties or stakeholders. Effective management of UICs can mean the difference between success and failure, in terms of technology transfer and research commercialization. This research paper focuses on the micro-level analysis of UICs and in particular the project management practices that can help major UICs deliver benefits and broader societal impact. PM has been evolving toward more hybrid approaches involving both traditional and agile practices. A conceptualization of a hybrid approach is presented based on a literature review. This conceptualization is then used as a starting point for exploratory empirical research. Participant observation, document analysis, and thirty semi-structured interviews were conducted in a large UIC case study to help identify PM practices and check their relevance. Data analysis led to a framework comprising 29 transversal or must-have practices distributed throughout the project lifecycle and 30 contingent or optional practices, divided into traditional, agile and common. This research extends the existing knowledge on UICs by giving a micro-level perspective on managing UIC projects and providing evidence of the adoption of hybrid approaches to assure the overall governance of significant inter-organizational endeavors. The framework provides a roadmap for future major UIC projects.
RESUMEN
We describe the population-based susceptible-exposed-infected-removed (SEIR) model developed by the Irish Epidemiological Modelling Advisory Group (IEMAG), which advises the Irish government on COVID-19 responses. The model assumes a time-varying effective contact rate (equivalently, a time-varying reproduction number) to model the effect of non-pharmaceutical interventions. A crucial technical challenge in applying such models is their accurate calibration to observed data, e.g. to the daily number of confirmed new cases, as the history of the disease strongly affects predictions of future scenarios. We demonstrate an approach based on inversion of the SEIR equations in conjunction with statistical modelling and spline-fitting of the data to produce a robust methodology for calibration of a wide class of models of this type. This article is part of the theme issue 'Data science approaches to infectious disease surveillance'.
Asunto(s)
COVID-19 , Susceptibilidad a Enfermedades , Humanos , Modelos Estadísticos , SARS-CoV-2RESUMEN
BACKGROUND: Vaginal epithelial abnormalities (VEA) are a common complication associated with pessary use. The objective of this study was to determine if there is a host pro-inflammatory response associated with pessary use and VEA. METHODS: Patients wearing pessaries for at least two weeks for the management of pelvic organ prolapse and/or urinary incontinence were screened for eligibility. Vaginal swabs were collected from women with VEA (cases) and without VEA (controls). Cases were matched to controls in a 1:3 ratio. Cytokine analysis of the collected samples was performed using multiplex analysis to determine the concentrations of interleukin (IL)6, interferon alpha 2 (IFNα2), tumor necrosis factor alpha (TNFα) and IL1ß. A cross-sectional analysis was performed, comparing vaginal cytokine concentrations in women with and without VEA. RESULTS: We enrolled 211 patients in this analysis: 50 cases and 161 controls. The median concentrations (pg/mL) of the four cytokines for cases and controls respectively were; IL6: 6.7 (IQR <2.9 [the lower limit of detection, LLD]-14.2) and < 2.9 (LLD) (IQR <2.9 [LLD]-5.5), IFNα2: 8.2 (IQR 6.1-13.9) and 7.9 (IQR 3.9-13.6), TNFα: 15.2 (IQR 6.1-30.4) and 4.68 (IQR <2.3 [LLD]-16.3), IL1ß 195.7 (IQR 54.5-388.6) and 38.5 (IQR 6.7-154.9). The differences in median cytokine levels were statistically higher in cases for IL6, TNFα, and IL1ß (all p < 0.001) compared to controls. Older age (OR: 1.062, 95% CI, 1.015-1.112), lower BMI (OR: 0.910, 95% CI, 0.839-0.986) and presence of VEA at last check (OR: 5.377, 95% CI, 2.049-14.108) were associated with higher odds of having VEA on multivariate analysis. CONCLUSION: Pro-inflammatory cytokines, specifically IL6, TNFα, and IL1ß, are elevated in pessary-wearing patients who have VEA. Additional prospective studies are needed to assess baseline vaginal inflammatory profiles before and after pessary placement to understand VEA formation in pessary patients.
Asunto(s)
Prolapso de Órgano Pélvico , Pesarios , Estudios Transversales , Femenino , Humanos , Interleucina-6 , Prolapso de Órgano Pélvico/complicaciones , Pesarios/efectos adversos , Factor de Necrosis Tumoral alfaRESUMEN
Mesoamerica and the Caribbean form a region comprised by middle- and low-income countries affected by the COVID-19 pandemic differently. Here, we ask whether the spread of COVID-19, measured using early epidemic growth rates (r), reproduction numbers (R t ), accumulated cases, and deaths, is influenced by how the 'used territories' across the regions have been differently shaped by uneven development, human movement and trade differences. Using an econometric approach, we found that trade openness increased cases and deaths, while the number of international cities connected at main airports increased r, cases and deaths. Similarly, increases in concentration of imports, a sign of uneven development, coincided with increases in early epidemic growth and deaths. These results suggest that countries whose used territory was defined by a less uneven development were less likely to show exacerbated COVID-19 patterns of transmission. Health outcomes were worst in more trade-dependent countries, even after controlling for the impact of transmission prevention and mitigation policies, highlighting how structural effects of economic integration in used territories were associated with the initial COVID-19 spread in Mesoamerica and the Caribbean.
RESUMEN
BACKGROUND: Mucosal-associated invariant T (MAIT) cells are unconventional T cells which recognize microbial metabolites presented by the major histocompatibility complex class I-related molecule MR1. Although MAIT cells have been shown to reside in human and murine skin, their contribution to atopic dermatitis (AD), an inflammatory skin disease associated with barrier dysfunction and microbial translocation, has not yet been determined. METHODS: Genetic deletion of MR1 and topical treatment with inhibitory MR1 ligands, which result in the absence and functional inhibition of MAIT cells, respectively, were used to investigate the role of MR1-dependent immune surveillance in a MC903-driven murine model of AD. RESULTS: The absence or inhibition of MR1 arrested AD disease progression through the blockade of both eosinophil activation and recruitment of IL-4- and IL-13-producing cells. In addition, the therapeutic efficacy of phototherapy against MC903-driven AD could be increased with prior application of folate, which photodegrades into the inhibitory MR1 ligand 6-formylpterin. CONCLUSION: We identified MAIT cells as sentinels and mediators of cutaneous type 2 immunity. Their pathogenic activity can be inhibited by topical application or endogenous generation, via phototherapy, of inhibitory MR1 ligands.