Nontuberculous mycobacterial myositis in dermatomyositis with long-term use of immunosuppressant: a case report.

Inflammatory myopathies, such as polymyositis and dermatomyositis, are systemic inflammatory disorders that affect skeletal muscles and internal organs. The treatment of inflammatory myopathies usually involves long-term use of high doses of steroids and/or immunosuppressants, making patients susceptible to opportunistic infections. Unfortunately, infections are a leading cause of morbidity and mortality in patients with inflammatory myopathies. Musculoskeletal nontuberculous mycobacterial infections are rare. Nontuberculous mycobacterial infections are easily overlooked owing to their rarity, leading to delayed diagnosis and treatment, indolent clinical course, and difficulty isolating the pathogen. Nontuberculous mycobacterial infections are a growing health concern because of their increasing incidence and the need for prolonged treatment. In patients with connective tissue diseases, immunosuppressant use may lead to an increased risk of nontuberculous mycobacterial infection with a poor prognosis, which highlights the need for early diagnosis and treatment. Herein, we report the case of a 59-year-old man diagnosed with dermatomyositis, who had prolonged use of immunosuppressants and developed a disseminated soft tissue infection in both thighs caused by Mycobacterium abscessus. Multimodal images were obtained using magnetic resonance imaging, ultrasonography, and computed tomography. A strong suspicion of possible combined opportunistic infections and appropriate staining is essential in diagnosing nontuberculous mycobacterial myositis.

A polymer in a crowded and confined space: effects of crowder size and poly-dispersity.

DNA compaction in a bacterial cell is in part carried out by entropic (depletion) forces induced by "free" proteins or crowding particles in the cytoplasm. Indeed, recent in vitro experiments highlight these effects by showing that they alone can condense the E. coli chromosome to its in vivo size. Using molecular dynamics simulations and a theoretical approach, we study how a flexible chain molecule can be compacted by crowding particles with variable sizes in a (cell-like) cylindrical space. Our results show that with smaller crowding agents the compaction occurs at a lower volume fraction but at a larger concentration such that doubling their size is equivalent to increasing their concentration fourfold. Similarly, the effect of polydispersity can be correctly mimicked by adjusting the size of crowders in a homogeneous system. Under different conditions, however, crowding particles can induce chain adsorption onto the cylinder wall, stretching the chain, which would otherwise remain condensed.

Chromosome-like organization of an asymmetrical ring polymer confined in a cylindrical space.

To what extent does a confined polymer show chromosome-like organization? Using molecular dynamics simulations, we study a model Escherichia coli (E. coli) chromosome: an asymmetrical ring polymer, formed by small monomers on one side and big monomers on the other confined in a concentric-shell or simple cylinder with closed ends. The ring polymer is organized in the way observed for the E. coli chromosome: if the big monomers are assumed to be localized in the inner cylinder, the two "subchains" forming the ring are spontaneously partitioned in a parallel orientation with the "body" (big-monomer) chain linearly organized with a desired precision and the crossing (small-monomer) chain residing preferentially in the peripheral region. Furthermore, we show that the introduction of a "fluctuating boundary" between the two subchains leads to a double-peak distribution of ter-proximate loci, as seen in experiments, which would otherwise remain single-peaked. In a simple cylinder, however, a chromosome-like organization of the ring polymer typically requires an external mechanism such as cell-wall attachment. Finally, our results clarify to what degree the spatial organization of the chromosomes can be accomplished solely by ring asymmetry and anisotropic confinement.

Interleukin-17 increases the expression of Toll-like receptor 3 via the STAT3 pathway in rheumatoid arthritis fibroblast-like synoviocytes.

We examined the effect of interleukin-17 (IL-17) on the expression of Toll-like receptors (TLRs) in fibroblast-like synoviocytes (FLS) from patients with rheumatoid arthritis (RA) and osteoarthritis (OA). We investigated the region downstream of IL-17 for TLR expression. We also investigated the downstream signals responsible for the effect of IL-17 in TLR expression. Levels of IL-17 protein in the serum and synovial fluid of RA and OA patients were measured by ELISA. The IL-17 mRNA expression in peripheral blood mononuclear cells and synovial fluid mononuclear cells was measured by RT-PCR. RA and OA FLS were incubated with IL-17 and/or IL-23 for 24 hr. To block the signal transducer and activator of transcription 3 (STAT3) pathway, FLS were treated with S3I-201 before incubation with IL-17 and IL-23. Synovial tissue samples from RA and OA patients were stained with antibodies to IL-17, TLR2, TLR3, TLR4, STAT3 and phospho-STAT3. Levels of IL-17 protein were higher in the serum and synovial fluid from RA patients compared with those from OA patients. The IL-17 mRNA expression in synovial fluid monocytes was also higher in RA than in OA patients. Immunohistochemical staining showed greater expression of IL-17, TLR2, TLR3 and TLR4 in synovial samples from RA compared with OA patients. Interleukin-17 increased the expression of TLR2, TLR3 and TLR4 in RA FLS; IL-23 augmented the IL-17-induced expression of TLR2, TLR3 and TLR4 in RA FLS. Blocking STAT3 with S3I-201 reduced IL-17-induced TLR3 expression in RA FLS. Our results suggest that IL-17 is a major cytokine in pathogenesis on RA. The IL-17 influences the innate immune system by increasing the synovial expression of TLR2, TLR3 and TLR4. We may control TLR3 expression via the STAT3 pathway in RA FLS.

IL-32 aggravates synovial inflammation and bone destruction and increases synovial natural killer cells in experimental arthritis models.

This study was performed to investigate the effects of IL-32 on joint inflammation, bone destruction, and synovial cytokine expressions, and on synovial natural killer (NK) cell expressions in collagen-induced arthritis (CIA). CIA was induced by type II collagen in DBA1 mice, and phosphate-buffered saline (PBS group) or IL-32 (IL-32 group) were injected into both knee joints at day 28 and 32, then mice were killed at day 35. Severity of synovial inflammation and bone destruction was determined by histological scoring method, and synovial cytokine expressions such as IL-1ß, TNF-α, IL-17, IL-18, IFN-γ, IL-21, and IL-23 were measured by real-time RT-PCR and western blot. Synovial NK cell expressions were determined by real-time RT-PCR, western blot and immunohistochemistry, and chemokines and chemokine receptors expressions that are associated with NK cell migration were determined by real-time RT-PCR. Scores of synovial inflammation and bone destruction, synovial expressions of IL-1ß, TNF-α, IL-18, and IFN-γ were significantly increased in IL-32 group compared with PBS group. Synovial expressions of NK cell, and chemokines (CCL2 and CXCL9) and chemokine receptors (CCR2 and CCR5) that are associated with NK cell migration were significantly increased in IL-32 group compared with PBS group. IL-32 aggravated joint inflammation and bone destruction and increased synovial expressions of inflammatory cytokine and NK cells in CIA. These results suggest that IL-32 play a role in joint inflammation and bone destruction, and IL-32 might be a new target for treatment of rheumatoid arthritis.

Inertial effects on the Brownian gyrator.

The recent interest into the Brownian gyrator has been confined chiefly to the analysis of Brownian dynamics both in theory and experiment despite the applicability of general cases with definite mass. Considering mass explicitly in the solution of the Fokker-Planck equation and Langevin dynamics simulations, we investigate how inertia can change the dynamics and energetics of the Brownian gyrator. In the Langevin model, the inertia reduces the nonequilibrium effects by diminishing the declination of the probability density function and the mean of a specific angular momentum, j_{θ}, as a measure of rotation. Another unique feature of the Langevin description is that rotation is maximized at a particular anisotropy while the stability of the rotation is minimized at a particular anisotropy or mass. Our results suggest that the Langevin dynamics description of the Brownian gyrator is intrinsically different from that with Brownian dynamics. In addition, j_{θ} is proven to be essential and convenient for estimating stochastic energetics such as heat currents and entropy production even in the underdamped regime.

IL-17 increases cadherin-11 expression in a model of autoimmune experimental arthritis and in rheumatoid arthritis.

IL-17 plays important roles in synovial inflammation and bone destruction in the mouse model of autoimmune arthritis and in rheumatoid arthritis (RA). Cadherin-11 determines the behavior of synovial cells in their proinflammatory and destructive tissue response in inflammatory arthritis, and promotes the invasive behavior of fibroblast-like synoviocytes (FLS). The purpose of this study was to examine the effect of IL-17 on the expression of cadherin-11 in autoimmune experimental arthritis and in RA synovium. The severity of synovial inflammation and bone destruction were examined in IL-17-injected knee joints of mice with collagen-induced arthritis (CIA). Cadherin-11 expression was examined in the synovium of mice with CIA, of IL-1 receptor antagonist (IL-1Ra)-deficient mice and of patients with RA and osteoarthritis (OA). Cadherin-11 expression was also examined in the synovium of IL-17 injected knee joints from CIA mice and in IL-17-stimulated FLS of CIA mice and RA patients. IL-17 aggravated synovial inflammation and bone destruction in CIA. By immunohistochemistry, cadherin-11 expression was increased in the synovium of mice with CIA and IL-1Ra-deficient mice and in patients with RA. Synovial cadherin-11 expression in IL-17-injected knee joints, measured by real-time RT-PCR, Western blot and immunohistochemistry, was increased in CIA. Cadherin-11 expression was significantly increased by IL-17 in cultured FLS of CIA mice and RA patients, and these increases were blocked by NF-κB inhibitors. IL-17 increased the expression of cadherin-11 in vivo and in vitro, which implies that an IL-17-induced increase of cadherin-11 is involved in IL-17-induced aggravation of joint destruction and inflammation.

Interleukin 17 (IL-17) increases the expression of Toll-like receptor-2, 4, and 9 by increasing IL-1beta and IL-6 production in autoimmune arthritis.

OBJECTIVE: To examine the effect of interleukin 17 (IL-17) on the expression of Toll-like receptor (TLR)-2, 4, and 9 in collagen-induced arthritis (CIA) in mice. METHODS: On Days 28 and 32 after induction of CIA in mice, phosphate-buffered saline (PBS group) or IL-17 (IL-17 group) was injected into both knee joints. On Day 35, mice were sacrificed. The severity of knee joint arthritis, synovial inflammation, and bone destruction was measured by a scoring system using macrography and histological analysis. Synovial expression of TLR-2, 4, 9, IL-17, IL-1beta, tumor necrosis factor-alpha (TNF-alpha), and IL-6 was determined by real-time PCR and immunohistochemistry. Synoviocytes of CIA mice were cultured with IL-17 and with neutralizing antibodies to cytokine, and the expression of TLR-2, 4, 9, IL-1beta, TNF-alpha, and IL-6 was determined by real-time RT-PCR. RESULTS: In CIA mice, knee arthritis scores, synovial inflammation, bone destruction scores, and expression of synovial TLR-2, 4, and 9, IL-17, IL-1beta, TNF-alpha and IL-6 were higher in the IL-17 and PBS groups than in normal DBA1 mice. These variables were also significantly higher in the IL-17 group than in the PBS group. In CIA synoviocytes, IL-17 increased the expression of TLR-2, 4, and 9, and this effect was significantly alleviated by neutralizing antibodies to IL-17, IL-1beta, and IL-6. CONCLUSION: IL-17 aggravates joint inflammation and destruction, and increases the synovial expression of TLR-2, 4, and 9 by increasing IL-1beta and IL-6. These results imply that the IL-17-induced increase in expression of TLR-2, 4, and 9, and IL-1beta and IL-6 production are involved in the IL-17-induced aggravation of arthritis.