Clinical Characteristics of H1N1 Influenza A-Associated Mild Encephalopathy with Reversible Splenial Lesion: 4 Pediatric Cases.

OBJECTIVE: Mild encephalopathy with reversible splenial lesion (MERS) is associated with a variety of infections and anti-epileptic drug withdrawal. Here we report the clinical characteristics of H1N1 influenza A-associated MERS based on our experience of four pediatric cases. METHODS: A detailed retrospective analysis of four patients with H1N1 influenza A-associated MERS was performed at Guangzhou Women and Children's Medical Center. RESULTS: All patients exhibited mild influenza-like illness and seizures. Three patients presented with a new-onset seizure with fever after 5 years of age. 75% patients had altered mental status. For all four patients, influenza A (H1N1) viral RNA was detected in throat swab specimens at least twice. Brain magnetic resonance images revealed similar ovoid lesions in the corpus callosum, mainly in the splenium and for one patient in the splenium and genu of the corpus callosum. Only one patient had an abnormal electroencephalogram tracing. Cells and protein in the cerebrospinal fluid were normal in all patients. All patients received oseltamivir and one patient received intravenous immunoglobulin. As a result, all patients fully recovered after 2 months and showed no neurologic sequelae at discharge. CONCLUSION: This case series provides insight towards clinical features of H1N1 influenza A-associated MERS.

The role of the lactadherin in promoting intestinal DCs development in vivo and vitro.

Lactadherin, as one of the immune components in the breast milk, might play a role in the intestinal immune system of newborn. Therefore, we investigated the effect of lactadherin-feeding in early time on the development of intestinal immune system compared with naturally rearing and artificially rearing (non-lactadherin). In the present study, we observed that the Peyer's Patches (PP) from the pups of artificially reared group with lactadherin added were characterized by an excess of OX62(+)CD4(+)SIRP(+) DC cells and a higher expression of CD3(+)CD4(+)CD25(+)T cells. Additionally, this study also demonstrated that IL-10 production was dramatically increased when lactadherin was present in culture medium compared with lactadherin-absent culture. These results suggested that lactadherin could adjust intestinal DCs activity, induce CD3(+)CD4(+)CD25(+)T cell differentiation, and enhance IL-10 production.

Morphology and ontogeny of dendritic cells in rats at different development periods.

AIM: To study the morphology and ontogeny of dendritic cells of Peyer's patches in rats at different development periods. METHODS: The morphometric and flow cytometric analyses were performed to detect all the parameters of villous-crypts axis and the number of OX62(+)DC, OX62(+)CD4(+)SIRP(+)DC, and OX62(+)CD4(-)SIRP(-)DC in the small intestine in different groups of rats. The relationship between the parameters of villous-axis and the number of DC and DC subtype were analyzed. RESULTS: All morphometric parameters changed significantly with the development of pups in the different age groups (F = 10.751, 12.374, 16.527, 5.291, 3.486; P = 0.000, 0.000, 0.000, 0.001, 0.015). Villous height levels were unstable and increased from 115.24 microm to 140.43 microm as early as 3 wk postpartum. Villous area increased significantly between 5 and 7 wk postpartum, peeked up to 13817.60 microm(2) at 7 wk postpartum. Villous height and crypt depth ratios were relatively stable and increased significantly from 2.80 +/- 1.01 to 4.54 +/- 1.56, 9-11 wk postpartum. The expression of OX62(+)DC increased from 33.30% +/- 5.80% to 80% +/- 17.30%, 3-11 wk postpartum (F = 5.536, P = 0.0013). OX62(+)CD4(+)SIRP(+)DC subset levels detected in single-cell suspensions of rat total Peyer's patch dendritic cells (PP-DCs) increased significantly from 30.73% +/- 5.16% to 35.50% +/- 4.08%, 5-7 wk postpartum and from 34.20% +/- 1.35% to 43.60% +/- 2.07% 9-11 wk postpartum (F = 7.216, P = 0.005). CONCLUSION: This study confirms the age-related changes in villous-crypt axis differentiation in the small intestine. Simultaneously, there are also development and maturation in rat PP-DCs phenotypic expression. Furthermore, the morphological changes of intestinal mucosa and the development of immune cells (especially DC) peaked at 9-11 wk postpartum, indicating that the intestinal mucosae reached a relatively mature state at 11 wk postpartum.