Interleukin-5 Antagonist Monoclonal Antibody Therapy Improves Symptoms and Reduces Steroid Dependence in Eosinophilic Myocarditis Patients.

Eosinophilic myocarditis (EM) is a rare disease associated with significant morbidity and mortality. This case series follows the clinical courses of 3 patients with EM. The use of mepolizumab, an anti-interleukin-5 monoclonal antibody, as an adjunctive treatment was associated with stabilization of cardiac function and improved long-term outcomes.

Resource availability controls fungal diversity across a plant diversity gradient.

Despite decades of research, the ecological determinants of microbial diversity remain poorly understood. Here, we test two alternative hypotheses concerning the factors regulating fungal diversity in soil. The first states that higher levels of plant detritus production increase the supply of limiting resources (i.e. organic substrates) thereby increasing fungal diversity. Alternatively, greater plant diversity increases the range of organic substrates entering soil, thereby increasing the number of niches to be filled by a greater array of heterotrophic fungi. These two hypotheses were simultaneously examined in experimental plant communities consisting of one to 16 species that have been maintained for a decade. We used ribosomal intergenic spacer analysis (RISA), in combination with cloning and sequencing, to quantify fungal community composition and diversity within the experimental plant communities. We used soil microbial biomass as a temporally integrated measure of resource supply. Plant diversity was unrelated to fungal diversity, but fungal diversity was a unimodal function of resource supply. Canonical correspondence analysis (CCA) indicated that plant diversity showed a relationship to fungal community composition, although the occurrence of RISA bands and operational taxonomic units (OTUs) did not differ among the treatments. The relationship between fungal diversity and resource availability parallels similar relationships reported for grasslands, tropical forests, coral reefs, and other biotic communities, strongly suggesting that the same underlying mechanisms determine the diversity of organisms at multiple scales.

Hypereosinophilic Syndrome.

Hypereosinophilic syndrome consists of a group of disorders characterized by abnormal accumulation of eosinophils in the blood or peripheral tissues, independent of known secondary causes of eosinophilia such as parasitic infection. Clinical manifestations of the condition are highly variable, ranging from asymptomatic eosinophilia to severe tissue damage and end-organ failure. This entity has been recognized for decades, with early studies identifying distinct groups of patients with differing symptoms, exam findings, laboratory abnormalities, and prognosis. In the past, these patients were treated with non-targeted immunosuppressive agents, often with limited efficacy. More recently, advances in the knowledge of eosinophil biology and molecular diagnostics have allowed for more specific delineation of the many disease subgroups that characterize hypereosinophilic syndrome. Identification of these groups has led to a personalized management approach to the condition, with improved diagnostic techniques as well as stratification of patients into more effective treatment groups. This review will discuss the evolution of the definition of hypereosinophilic syndrome, outline current disease classifications, provide a guide for evaluation and monitoring, and discuss current and future therapeutic modalities.

Evaluation and Differential Diagnosis of Persistent Marked Eosinophilia.

Peripheral blood eosinophilia is commonly encountered in clinical practice. The causes of peripheral blood eosinophilia are varied, ranging from benign eosinophilia to malignancy. A careful history and physical examination along with directed clinical evaluation may help determine the cause. When uncontrolled, peripheral blood eosinophilia may result in end-organ damage and life-threatening complications. This article summarizes the differential diagnosis and evaluation of persistent marked eosinophilia.