RESUMEN
The antigenic specificity of T cells occurs via generation and rearrangement of different gene segments producing a functional T cell receptor (TCR). High-throughput sequencing (HTS) allows in-depth assessment of TCR repertoire patterns. There are limited data concerning whether TCR repertoires are altered in inflammatory bowel disease. We hypothesized that pediatric ulcerative colitis (UC) patients possess unique TCR repertoires, resulting from clonotypical expansions in the gut. Paired blood and rectal samples were collected from nine newly diagnosed treatment-naive pediatric UC patients and four healthy controls. DNA was isolated to determine the TCR-ß repertoire by HTS. Significant clonal expansion was demonstrated in UC patients, with inverse correlation between clinical disease severity and repertoire diversity in the gut. Using different repertoire variables in rectal biopsies, a clear segregation was observed between patients with severe UC, those with mild-moderate disease and healthy controls. Moreover, the overlap between autologous blood-rectal samples in UC patients was significantly higher compared with overlap among controls. Finally, we identified several clonotypes that were shared in either all or the majority of UC patients in the colon. Clonal expansion of TCR-ß-expressing T cells among UC patients correlates with disease severity and highlights their involvement in mediating intestinal inflammation.
Asunto(s)
Células Clonales/fisiología , Colitis Ulcerosa/inmunología , Colon/inmunología , Genes Codificadores de la Cadena beta de los Receptores de Linfocito T/genética , Receptores de Antígenos de Linfocitos T alfa-beta/metabolismo , Especificidad del Receptor de Antígeno de Linfocitos T/genética , Linfocitos T/fisiología , Adolescente , Proliferación Celular , Niño , Selección Clonal Mediada por Antígenos , Colitis Ulcerosa/genética , ADN/análisis , Progresión de la Enfermedad , Humanos , Activación de Linfocitos , Receptores de Antígenos de Linfocitos T alfa-beta/genéticaRESUMEN
Raynaud's phenomenon (RP) is rare in young children. We describe two infants with severe RP, manifesting as fingertip necrosis, who were resistant to conventional vasodilators and were treated successfully with iloprost, a prostacyclin analogue. The application of iloprost is safe and should be considered in children with threatening ischemic digits.
Asunto(s)
Iloprost/uso terapéutico , Enfermedad de Raynaud/tratamiento farmacológico , Vasodilatadores/uso terapéutico , Femenino , Dedos/irrigación sanguínea , Dedos/patología , Humanos , Lactante , Masculino , Necrosis , Enfermedad de Raynaud/patologíaRESUMEN
A survey of HBsAg among Jerusalem blood donors revealed a prevalence of 0.89% and a predominance of subtype ay (85%) compared with ad (15%). A simultaneous survey of patients with HBsAg-positive viral hepatitis revealed a similar predominance of ay (85%) compared with ad (15%). The uniform distribution of the dominant ay subtype among both carriers and patients, representing a diversity of ethnic and national origins, supports the premise that ad and ay subtypes are preferentially correlated with regional epidermiologic, rather than host or disease-related factors.